MEDICAL STUDENT'S 

VADE MECUM) 



CONTAINING EXAMINATIONS UPON 



ANATOMY, CHEMISTRY, MATERIA MEDIC A, 
SURGERY, PRACTICE OF MEDICINE, 
OBSTETRICS, AND POISONS. 



Adapted to the use of Medical Students generally. 



BY GEORGE MENDENHALL, M. D. 

Honorary member of the Philadelphia Medical Society, 
Physician to the Cincinnati Dispensary, &c. 



CINCINNATI: 

PUBLISHED BY JACOB ERNST, 206 MAIN STREET. 

PHILADELPHIA: 

LINDSAY Si BLAKISTON, CORNER FOURTH AND CHESTNUT STS, 

1844, 



Entered according to the Act of Congress, in the year 1844, 
by George Mendenhall, M. D., in the Clerk's Office of the 
District Court of the United States, for the Stato of Ohio. 



PREFACE. 



The object of this little volume is to provide the 
Student of Medicine with a short and succinct view 
of the most important facts and principles which en- 
gage his attention during his Academic studies, in 
order that he may refresh, and fix more firmly upon 
his memory, what he has read and heard; as well as 
to enable him properly to arrange his knowledge, so as 
to make a right use of it. With such a Vade Mectjm, 
every leisure moment, whether in the class-room or 
elsewhere, may be profitably employed* 

The author was fully aware that many works of a 
similar kind have been published; but he had reason, 
when a student, to be dissatisfied with all of them. 
To supply what he considered their deficiencies, 
were the reasons for undertaking this work, Whether 
he has accomplished his object, he leaves to the 
student to decide. 

The sources to which he has been mostly indebted 
in forming this compilation, are Horner's and Paxtoirs 
Anatomy; Turner's and Hare's Chemistry; Gibson's 
and Cooper's Surgery; Mussey's Lectures; United 
States' Dispensatory; Wood's Syllabus; Dewees' and 
Rigby's Midwifery; Eberle's Practice of Medicine; 
Gerhard's Clinical Guide ; Locke's Lecture on Toxi- 
cology; Orfila on Poisons, &c. &c. 

Cincinnati, November, 1844. 



CONTENTS, 



PART I. 

ANATOMY. 



Divisions of Anatomy. 
Skeleton, 

Trunk, 

Head, 

Sutures, 

Superior Extremities, 
Interior Extremities. 

Cartilage. 

Ligaments, 

Integuments, 

Muscles, 

Organs of Digestion, - 
Abdomen, - 
Chylopoietic Viscera, 



Caloric, 
Light, 
Electricity, 
Specific Gravity, 
Nomenclature, 
Affinity, 
Oxygen 
Hydrogen, 
Nitrogen, 
Carbon, 
Sulphur, 
Phosphorus, 
Boron, - 
Silicon, 
Selenium, 
Chlorine, 
iodine, - 
Bromine, 
fluorine, 
Ammonia, 

Compounds of Hydrogen 
and Carbon, 



9i Assistant Chylopoietic 

10 viscera, - - 39 
12 Urinary Organs, - -41 
1 4 ; M al e O rgan s o f G e n e r a - 
18| tion, - - -42 
19jFemale Organs of Gene- 

20 ration,- - - 44 

2l!Organs of Respiration, 45 

z&'Organs of Circulation, - 48 

24|Absorbent System, - 56 

25;Nervous System, . - 57 

32 Senses, - - - 63 

35 Sympathetic Nerve, - 65 

37jSpinal N erves, - - 67 

PART II. 

CHEMISTRY. 

69 Compounds of Hydrogen 

73 and Sulphur, - 103 

74 j " Hydrogen 

75 and Phosphorus, - ib 
ib u Nitrogen 

77 and Carbon, - 104 

78 Metals, jh 
9; Potassium, - - ]06 

Sodium, - - - 107 

Lithium, - - 108 

Barium, - - . j[, 

Strontium, - - 109 

Calcium, - - - 110 

Magnesium, - - ib 

Aluminum, - - 111 

Manganese or Man^a- 

ncsium, . - . {[, 

Iron, - . - 112 

Zinc, - - . H4 

Tin, - - - -i|6 

Cobalt, - . = jh 

- 10ll Nickel, - - . no 



80 
83 
84 
86 
87 



90 
97 
98 
99| 
101 



vi 



CONTENTS 



Arsenic, - - 116 
Antimony, - - 118 
Copper, " - - 119 
Lead, - - -120 
Mercury, - - 121 
Silver, - - - 124 
Gold, 125 
Platinum, - - ib 
Alloys and Amalgams, 126 
Salts, 

Organic Chemistry, - 128 
Vegetable Chemistry, - ib 
Vegetable Acids, - 129 
Vegetable Alkalies, - 131 
Neutral Substances, the 
Oxygen and Hy- 
drogen of which 



are in the same ra- 
tio as in water, - 

Oils, 
Resins, 

Bituminous Substances 
Alcohol, 
Ether, - 
Coloring Matters, 
Other Vegetable Prin- 
ciples, 
Fermentation, - 
Germination, 
Animal Chemistry, 
Analytical Chemistry, 
Table of Symbols and 
Equivalents, - 



PART III. 

MATERIA MEDICA AND PHARMACY. 



Definitions, &c, - 
Classification, - 
Astringents, 

Vegetable, 

Mineral, 
Tonics, 

Pure Bitters, - 

Bitters of peculiar or 



modified properties 149 



1 39| Alterative, 
14l|Expectorants, 
143jEmmenagogues, 
143 Epispastics, - 
146j Rubefacients, - 
147|Escharotics, 
148; Demulcents, 
|Emollients, 



151 
153 
155 



Aromatic s, 
Mineral tonics, 
Arterial Stimulants, - 
Nervous Stimulants or 

Antispasmodics, - 
Cereb. Stim. or Narcotics, 156 
Arterial Sedatives, 
Nervous Sedatives, 
Emetics, 
Cathartics, 

Vegetable, 

Mineral, 

Saline, 
Diuretics, 
D«aphoretics, 

Nauseating, 

Re friar grant, 



Diluents, 



Medicines, unclassified, 
Ergot, 

Nux Vomica, 
Arsenic, 
Mercury, 
Iodine, 
158j Antacids, - 
159|Antholmintics, - 
160 Table of Signs and Ab- 
breviations, 
Extempor. Prescriptions, 
Powders, 
Pills, 

Mixtures, - - - 
Solutions, 
Infusions, 
Weiohts and Measures, 



161 
162 
165 



166 
169 
ih 
170 



170 
171 
172 
173 
174 
175 
ib 
ib 
ib 
ib 
176 

ib 
ib 
ib 

177 
178 



179 
180 

ib 
181 
182 
185 

ih 
186 



CONTENTS. 



vii 



PART IV. 



Inflammation, 
Suppuration, 
Ulceration, - 
Mortification, 
Erysipelas, 
Furunculus, 
Anthrax, 
Pernio, 
Frost-bite, 
Burns, 

Wounds, • 

Absceses, 

Ulcers, 
Simple, 
Irritable, 

Scrofula, 

Cancer, 

Gonorrhoea, - 

Syphilis, - 



SURGERY 

187 
188 
ib 
189 
190 
ib 
191 
ib 



Pelvis, - 

Deformity of the Pelvis, 
Child's Head, 
Genital Organs, « • 239 
Menstruation, - - 241 
Derangement of the func- 
tion, - - - $42 
Pregnancy, - • 244 
The Membranes, - ib 
Placenta, - - 245 
Foetal Circulation, - ib 
Changes of the Uterus from 

Impregnation - 247 
Development of the Foetus 24' 



Fractures, - - - 200 

Luxations, - - 203 
Diseases of Bones and 

Joints, - - - 205 

Diseases of Arteries, 209 

Diseases of Veins, - 210 

Injuries of the Head, 211 

Diseases of the Eye, - 214 
ib Diseases of the Nose and 

192 Antrum, - - 221 

192 Diseases of the Mouth, 222 

195 Hernia, 224 

196 Artificial Anus, - - 228 
ii'Diseases of the Rectum, 229 
i&'Dis eases of the Testicle 

197| and Penis, - 230 
198 Diseases of the Urethra 

ih\ and Bladder, - 231 

z7>[Amputa + ion, - - 232 

PART V. 

OBSTETRICS. 

234 Obliquities of the Uterus, 251 
237iTerm of Utero-Gestation 251 
238 Labor, - - 252 



Natural Labor, and 

Presentations, - 355 
Mechanism of Labor in 

Head Presentations, 256 
Breech Presentations, 258 
Feet Presentations, ib 
Knee Presentations, 259 
Labor in which the 
Presentations arena- 
ural but rendered 
preternatural, - 259 



Extra-Uterine Pregnancy 248 The Forceps, - - 263 
Signs of Pregnancy, - 248 Locked or Impacted head 265 
Action of the Uterus, 250 Uterine Hemorrhage, ib 



Re trover, of the Uterus, 
Ant ever, of the Uterus, 



250 
251) 



Accidental, 
Unavoidable, 



260 
269 



CONTENTS. 



Puerperal Convulsions, 270 
Inversion of the Uterus, 271 
Twins, - - - 273 
Arm and Shoulder pre- 
sentations, - 273 

PART VI. 

THEORY AND PRACTICE OF MEDICINE. 
Of Disease, - - 278jEndocarditis, 
Semeiology and Diagno- (Rheumatism, - 
280Gout, 
284jVariola, - 
286 Varicella, - - 
287|Rubeola, 

288 Scarlatina, 

289 Hemorrhages, 
289 Phlegmasia Dolens, 



sis, 
Fever, 

" Intermittent, 
" Remittent, 
" Yellow, 
** Continued, 
" Typhoid, - 
" Typhus, 
Inflammations of the Al- 
imentary Canal, and 
Accessary Organs, 
Inflammations of the 

Nervous System, 
Inflammations of the 
Respiratory Organs, 
Phthisis, Pulmonalis, 
Nephritis, 
Cystitis, 
Pericarditis* 



291 



292 
296 



298 



Prolapsus of the Cord, 274 
Rupture of the Uterus, 275 
Deliveries where there is 
Deformity of Moth- 
er or Child. - 275 



309 
ib 
310 
311 
ib 
312 
ib 
313 
ib 
ib 
314 
3J5 
ib 



Apoplexy, 
Paralysis, - 
Epilepsy, 
Chorea, 

Convulsive Affections of 

Infants, - - 316 
Tetanus, - - ib 

Mental Derangements, ib 
305 Delirium Tremens, 317 
308, Asphyxia, - - 318 
^Diarrhoea, - - - 319 
i& ! Colic, - - - 320 

PART VII. 



Acids, 

Alkalies, 

Antimony, 

Arsenic, 

Barytes, 

Copper, 

Gold, 

Lead, 

Mercury, 

Nitre, 

Oxalic Acid, 
Silver, 
Tin, 



POISONS. 

322|Zinc, 
. 323 Narcotics, 
ib Opium, . 

f&jHydrocyanic Acid, - 

324 Buckeye, 
ii|Chlorine, 

325 Digitalis, 

ib Ipecacuanha, 
ib Jalap, 

ib Strammonium, - 

326 Nux Vomica, ^ - 
ib 1 Phosphorus, 

i& Stings of Insects, &c. 



ib 
ib 
ib 

327 
ib 
ib 
ib 

328 
ib 
ib 
ib 
ib 
ib 



MEDICAL STUDENT'S VADE MECUM. 



PART I.— ANATOMY. 



Q. What is Anatomy?- A. The science of organization. 

How is it divided? Into Vegetable and Animal. 

How is Animal Anatomy divided? Into Human and 

Comparative. 

What is Human Anatomy? The Anatomy of man. 

"What is Comparative Anatomy? The anatomy of all 
other animals except man. 

How is human anatomy divided? Into Descriptive or 
Special, General, and Pathological. 

What is Descriptive or Special Anatomy? That which 
describes the form, size, position, and connexions of organs. 

What is General Anatomy? That which treats of the 
structure of the simple tissues of the body. 

What is Pathological Anatomy? That which relates to 
the diseased structure of the organs. 

What are the simple tissues of the human body ? The 
Cellular, Adipose, Vascular, Nervous, Osseous, Fibrous, 
Cartilaginous, Fibro-Cartilaginous, Muscular, Erectile, Mu- 
cous, Serous, Dermoid, and Glandular, fourteen in number. 

Under what divisions is human anatomy studied ? Os- 
teology, or a description of the bones. Syndesmology, of the 
ligaments. Myology, of the muscles. Splanchnology, of the 
viscera. Adenology, of the glands. Angiology, of the 
vessels. Neurology, of the nerves. Dermology, of the skin. 

What are the inorganic elements of the body ? Carbon, 
nitrogen, oxygen, hydrogen, phosphorus, sulphur, iron, cal- 
cium, sodium, potassium, &c. 

What are the organic elements? Gelatin, fibrin, albu- 
men, mucous, fat, ccc. 

2 



16 



ANATOMY. 



Skeleton. 

What is the bony frame work of the human body called ? 
Skeleton. 

What is a natural skeleton? When the bones are held 
together by their natural connexions of ligaments, carti- 
lages, &c. 

What is an artificial skeleton? "When the bones are held 
together by artificial means. 

Suppose a line, called the median, drawn from the top of 
the head downward through the middle of the skeleton, 
will these two sides be similar? Yes, the bones of the two 
sides willbe perfectly alike : and where bones are divided, 
tho two halves will be symmetrical. 

What are the regional divisions of the skeleton? Head, 
Trunk, Superior, and Inferior extremities. 

What is the number of bones in persons of middle age? 
For the trunk — twenty-four true vertebrae, one sacrum, four 
coccygeal, two innominata, twelve ribs on each side, and 
one sternum. For the head — eight in the cranium, fourteen 
for the face, and one hyoid. For the upper extremities — 
thirty-four to each side. For the inferior extremities — thirty- 
two to each side. In all, two hundred and eleven, not in- 
cluding the bones of the tympanum and teeth. In early life 
the number is greater, and in old age diminished, by the 
growing together of bones originally distinct. 

How are bones divided in regard to their shape? Into 
ossa longa or long bones; ossa lata or broad bones; and ossa 
crassa or thick bones. 

What is an eminence on a bone called? Apophysis or 
process when united, and epiphysis when separated by 
cartilage. 

What other names are applied to eminences of bone 
depending upon their shape, situation, and use? Heads, 
when convex, roundish, and smooth. Necks, when smaller 
at the middle and increase towards the extremity. Condyles, 
when the head is large and unequally rounded. Tubercles, 
or tuberosities, when uneven, rough, and irregular. Spines 
or spinous processes, when sharp or pointed Cristae, when 
there are long and sharp elevations. Coronoid, if the ter- 
mination is in a sharp edge. Mastoid, styloid, coracoid, &c. 
from their resemblance to certain other things. Oblique, 



ANATOMY. 



transverse, &c, from situation. Trochanters, when they 
serve to turn a bone. 

What names are given to depressions ? Cotoloyd, when 
deep and cup-like. Alveoli, or sockets, as the sockets for 
the teeth; and glenoid, when superficial. 

How are bones divided in regard to density? Into com- 
pact and cellular; the former is situated external, and the 
latter internal. 

What is the composition of bones? Animal and earthy 
matter. The minute analysis of which is gelatin, 32 parts, 
phosphate of lime, 51 parts; carbonate of lime, 11 parts; 
fluate of lime, 2 parts; phosphate of magnesia, 1 part, and 
muriate of soda, 1 part. The bones also contain a little iron 
manganese, silex, alumine, and phosphate of ammonia. 

Upon which of these primary constituents does the hard- 
ness of bone depend ? The earthy, and may be obtained by 
calcination. 

How may the animal part be demonstrated? By immer- 
sion for some time in dilute muriatic acid, the earthy parts 
will be dissolved, leaving the animal. 

What is the structure of bones? It is fibrous and lami- 
nated, supplied with bloodvessels, nerves, and absorbents. 

What is meant by periosteum ? It is the fibrous mem- 
brane which surrounds bones except at their articular car- 
tilages, and receives the insertion of tendons, ligaments, 
aponeuroses, &c. Its use is also to conduct the blood vessels 
to the bones, and give protection and shape to them. 

What is meant by the medullary membrane ? It is a very 
delicate membrane lining the internal structure of bone 
which secretes the medulla, and serves the purpose of an 
internal periosteum. 

Are bones perfectly ossified at birth? No: the ends of 
the long bones are cartilaginous; the corpus and tarsus are 
nearly in the same state, and the processes generally ara 
very imperfectly developed. 

What are the stages of ossification? There are three. 
The first is the mucous or pulpy, which exists during the 
first month; second, cartilaginous, commencing with the 
second month; and third, osseous, which commences at the 
end of the second month in some of the bones : when ossifi- 
cation commences, the color of the cartilage becomes deeper 
and in the middle of a yellow color ; the vessels dilate, carry 



ANATOMY. 



red blood, and a red point is perceived in the centre of the 
cartilage, which is called punctum ossificationis, from which 
the deposit increases on its surface. The long bones com- 
mence by a small ring which extends itself. Tho flat bones 
commence by one Or more points and radiate to the peri- 
phery. The thick bones may have a single point or several, 
and they all grow by successive depositions on the outer 
surface or at the ends. 

At what age are bones most dense? At the middle 
period of life ; and as age advances they grow lighter, more 
cellular and brittle, and the proportion of animal matter is 
diminished. 

What is the process of the formation of callus? When a 
fracture takes place there is effusion of blood into it; the 
soft parts swell; the blood is absorbed, and while this is 
going on, there is an effusion of coagulating lymph ; an 
osseous ring is then formed around tho seat of fracture, with 
a pin in its centre. Next, the extremities of bone begin to 
fuse themselves together; which when complete, the bony 
ring and pin being superfluous, are absorbed, and the cavity, 
cellular structure, membrane, &c. are re-established. The 
process is entirely similar in other respects to the formation 
of new bone. In compound fractures, granulations fre- 
quently spring up from the surface of the bone in the same 
order as in the formation of new bone. 

Trunk. 

What constitutes the Trunk? The Spine, Thorax, and 
Pelvis. 

Where is the spine situated? At the posterior part of the 
trunk and extends from the head to the inferior opening of 
the pelvis. 

What composes it? It consists of twenty eight or twenty 
nine distinct pieces of which the upper twenty-four are true 
or moveable vertebras, the twenty-fifth is the sacrum or pelvic 
vertebra, and the remainder are the caudal vertebrae. 

What are the curvatures of the spine? The cervical por- 
tion is convex anteriorly and concave posteriorly : thoracic 
portion concave in front and convex behind; lumbar portion 
convex in front and concave behind; pelvic and caudal 
concave in front and convex behind; and depend upon the 
different degrees of thickness of the bodies of the vertebra* 
and the intervening cartilages. 



ANATOMY. 



ft 



How are the true vertebrae divided} Into seven cervical, 
twelve dorsal, and five lumbar. 

What does a vertebra consist of? A body, seven proces- 
ses (two transverse, one spinous, and four oblique), and a 
hollow for lodging the spinal marrow which is formed by- 
the body anteriorly and the processes posteriorly and laterly. 

What characterizes a cervical vertebra ? Smaller than the 
others; longest latterly ; spinal foramen large ; spinous pro- 
cess forked; transverse processes short, double, and perfo- 
rated .for the passage of the vertebral artery and vein. There 
are also differences between these vertebrae themselves. 

What is the peculiarity of the first cervical vertebra and 
what is its name ? It has no body or spinous process, being 
a simple ring and is called atlas. 

What is there peculiar to the second cervical.vertebra and 
what is its name I It has upon its upper part a process call- 
ed odontoides or dens and the vertebra itself is called verte- 
bra dentata. 

What characterizes a dorsal vertebra? Body longer an- 
tero-posteriorly and more cylindrical than the cervical, upper 
and lower margin marked with a small articular face for ar- 
ticulating with the ribs, spinal foramen small and round, 
diminishing in size from first to third, and these increase to 
the last. 

What characterizes a lumbar vertebra? Body larger; 
long diameter transverse ; spinal foramen triangular and 
larger than the dorsal; transverse processes long and stand 
out at right angles, spinous process thick, horizontal, and 
terminated in an oblong tubercle. 

Where is the sacrum situated and what characterizes it? 
It is at the posterior part of the pelvis, forms part of its su- 
perior boundary, and is the pedestal of the spine. It is trian- 
I -gular, concave before, and irregularly convex behind, where 
it is divided by spinous processes; articulates laterally with 
the ossa innominata, and originally consisted of five pieces. 
It has four anterior and four posterior foramina; and its canal 
is triangular. 

What are the characteristics of the coccyx? It resem- 
bles the sacrum, only much smaller, consists of four pieces 
united by fibro-cartilage, corresponds with the tails of ani- 
mals, and is articulated superiorly to the sacrum. 

What are the uses of the vertebral column? It gives a 



14 



ANATOMY. 



secure lodgement to the spinal marrow, is a line of support 
to the trunk, and the centre of its movements. 

Where are the ossa innominata situated? They are two 
in number and situated on either side of the sacrum, form 
the lateral and anterior parts of the pelvis, and articulate with 
the os femoris on each side by the acetabula. 

What are the original divisions of each os innominatum J 
Ilium, ischium, and pubis. 

What characterizes the ilium? It is the largest of the 
the three, forms the upper and rounded part of the innomi- 
natum, articulates with the sacrum, and forms two-fifths 
of the acetabulum. 

What characterizes the pubis? It is the anterior part of 
the innominatum and is the smallest of the three; it is com- 
posed of a body and two large branches, one running down- 
wards to join the ischium and the other backwards and up- 
wards to the ilium; it articulates with its fellow by a flat 
surface called the symphysis, it forms one fifth of the acetab- 
bulum, and contributes to the formation of the obturator 
foramen. 

What characterizes the ischium? It forms the posterior 
inferior part of the os innominatum, is next in size to the 
ilium, triangular in form, its anterior extremity bends up- 
wards to join the pubis which is the crus and the remainder 
is the body, the lower part of which is the tuberosity ; it 
forms two fifths of the acetabulum. 

What is meant by the Thorax ? It is the upper part of the 
trunk, and is formed by the dorsal vertebras behind, sternum 
in front, and by the ribs and their cartilages intermediate. 

How are the ribs divided ? Into seven true and fivo 
false. 

What characterizes the ribs? They are paraboloid, have 
an internal and external surface, an upper and lower margin, 
a sternal and vertebral extremity, an angle, head, tubercle, 
and neck. 

Where is the sternum situated? In the middle front part 
of the thorax, and is divided into three portions, the lower 
of which is sometimes called xyphoid cartilage. 

Head. 

How are the bones of the head divided ? Into those of the 
cranium and face. 
What bones constitute the cranium? The os frontis, o§ 



ANATOMY. 



15 



occipitis, two ossa parietalia, two ossa temporum, os ethmoi- 
des and the os sphenoides. These form the cavity for tho 
brain, which has three diameters; the antero-posterior ; from 
the lower part of the os frontis to the protuberance on the 
middle of the inferior surface of os occipitis, six and a half 
inches; the lateral includes the space between the superior 
margins of the ossa tempora, four and three-fourth inches ; 
and the vertical which is taken from the centre of the occipi- 
tal foramen to the centre of the suture between the parietal 
bones, four and a half inches. 

What are the characteristics of the os frontis? It forms 
the anterior, a portion of the superior, lateral, and inferior pa- 
rietes of the cranium ; external face convex, internal concave, 
symmetrical, and forms the upper and anterior part of the 
orbit. It has two internal and two external angular proces- 
ses, a nasal process, two superciliary ridges, a temporal ridge, 
two orbitar plates or processes, two elevations of the frontal 
sinuses, and it articulates with the parietal, ethmoidal, and 
sphenoidal bones of the cranium, and several of the face. 

What are the characteristics of the ossa parietalia? They 
form the superior and lateral parts of the middle of the crani- 
um, they are quadrilateral, convex externally, and concave 
internally. They articulate together, with the frontal, the 
sphenoid, the temporal, and the occipital bones. They have 
each a deep groove commencing at their anterior inferior 
angle internally, for the middle meningeal artery. 

What are the characteristics of the os occipitis? It is 
quadrilateral, resembling a trapezium, convex externally, and 
concave internally, both surfaces are modified by ridges and 
processes. It forms a large portion of the posterior and in- 
ferior parietes of the cranium, and has a large foramen called 
foramen magnum, which transmits the medulla spinalis, ner- 
vi accessorii, and the vertebral arteries and veins, the anteri- 
or condyloid foramen, which transmits the ninth pair of 
nerves, and the posterior condyloid, which transmits a cer- 
vical vein to the lateral sinus. It articulates with the parie- 
tal, temporal, and sphenoid bones. 

What are the characteristics of the ossa temporum ? They 
form portions of the inferior lateral parietes, and of the base 
of the cranium, have an irregular figure, and are divided in- 
to the anterior portion called squamous;, posterior, called 
mastoid, and the middle, or petrous portion. The mastoid 
portion has cells or sinuses which communicate with tho 



ANATOMY. 



tympanum. The elevations on each side are the mastoid, 
the zygomatic , the styloid, and the vaginal processes, 
the ridge internally, and the petrous portion. The depres- 
sions are the glenoid cavity, the fissura glasseri, a fossa be- 
hind the mastoid process, and the temporal. The foramina 
are the meatus auditorius internus and externus, the carotid, 
the stylo-mastoid, the eustachian canal, and the openings of 
the aqueduct of the cochlea and vestibule. They are con- 
nected to the sphenoid, parietal, and occipital, bones by 
sutures. 

What are the characteristics of the os sphenoides? It is 
symmetrical, but very irregular, and placed across the middle 
of the base of the cranium. It consists of a body and large pro- 
cesses called the greater and lesser wings, the latter of which 
are the apophyses of Ingrassias. There are also the ptery- 
goid, internal and external, anterior and posterior clinoid, 
sphenoidal or azygos, and olivary processes. The foramina 
are opticum, lacerum superius or sphenoidale, ovale, rotun- 
dum, spinale, and pterygoideum. It articulates above and 
in front with the vomer, frontal, ethmoidal, malar, and parie- 
tal bones; laterally with the temporal; behind with the occi- 
pital, and with the palate bones by the pterygoid processes. 

V/hat do these foramina severally transmit? The opti- 
cum transmits the optic nerve and ophthalmic artery; the 
lacerum superius transmits the third, fourth, first branch of 
the fifth, and the sixth pair of nerves; the rotundum trans- 
mits the second branch of the fifth pair of nerves; the ovale 
the third branch of the fifth pair; the spinale the middle ar- 
tery of the dura mater; and the pterygoideum the pterygoid 
nerve which is a recurrent of the second branch of the fifth 
pair. 

What are the .characteristics of the os ethmoides? It is 
situated between the orbitar processes of the os frontis; it is 
cuboidal, very light, and cellular. The part between the or- 
bitar processes superiorly is called the cribriform plate with 
the crista galli in the centre. 

What is meant by the pyramids of Wistar ? They are tri- 
angular hollow pyramids on the posterior part of each cellu- 
lar portion of the ethmoid bone consisting of a single cell ; 
aud the azygos process of the sphenoid bone is received be- 
tween them. They are found in children from three to eight 
years of age. The pyramid towards puberty becomes a part 



ANATOMY. 



17 



of the sphenoid bone and detaches itself from the ethmoid 
by a suture. 

What composes the face? Fourteen bones; thirteen of 
which are in the upper jaw. They are the ossa maxillaria 
superiora, ossa malar um, ossa nasi, ossa turbinata inferiora, 
ossa palati, and the vomer. The fourteenth is the os maxil- 
lare inferius. 

What are the characteristics of the ossa maxillaria supe- 
riora? They are distinguished by their superior size and 
composing nearly the whole front of the upper jaw. They 
also form a portion of the orbit of the eyes and have alveo- 
lar, malar, nasal, and palatine processes. They have also a 
large cavity in each called the antrum* highmorianum which 
communicates with the nose. They articulate with the fron- 
tal, nasal, unguiform, malar, and ethmoidal bones superior- 
ly; behind to the palate bones; in the middle to the vomer 
and to each other; and by the nasal surface to the inferior 
spongy. 

What are the characteristics of the ossa palati? They 
are placed posteriorly to the superior maxillary bones, be- 
tween them and the pterygoid processes of the sphenoid. — * 
They are each divided into three portions; the horizontal or 
palate plate, the vertical or nasal plate, and the orbitar or 
oblique plate. They have six articulations; viz: — with the 
maxillary bones, sphenoid, ethmoid, inferior spongy, vomer, 
and with each other. 

What are the characteristics of the ossa nasi? They are 
two in number and fill up the vacancy between the nasal pro- 
cesses of the superior maxillary bones, and form what is term- 
ed the bridge of the nose. They articulate with each other 
anteriorly, os frontis superiorly, upper maxillary posteriorly, 
and with the septum narium where they unite together in 
front. 

What are the characteristics of the ossa unguis? They 
are small and are placed at the internal side of Ihe orbit be- 
tween the nasal processes of the upper maxillary bone and 
the planar plate of the ethmoid ; assist in forming the ductus 
ad nasum, articulate loosely with the os frontis, upper maxil- 
lary, planar plate of the ethmoid, and inferior spongy bone of 
the nose. 

What are the characteristics of the ossa malarum ? They 
are situated at the external orbit of the eye and form the 



18 



ANATOMY. 



middle and external parts of the face. They are quadran- 
gular, with irregular margins, have superior and inferior 
orbitar, zygomatic, and maxillary processes. They articu- 
late on each side with the maxillary, frontal, sphenoidal, 
and temporal bones. 

What are the characteristics of the ossa spongiosa inferiof 
ra? They are situated at the inferior and lateral parts o 
the nose below the opening into the antrum highmorianum' 
they have a concave and convex surface with the concavity 
looking towards the maxillary bones. 

What are the characteristics of the vomer? It is placed 
between the nostrils, and forms a part of the septum. It ar- 
ticulates below with tSe nasal spine of the superior maxilla- 
ry and palate bones, and above to the nasal lamella of tha 
ethmoid and azygos processes of the sphenoid. 

What are the characteristics of the os maxillare inferius? 
It forms the lower boundary of the face and is capable of 
motion. It is composed of a body and two extremities or 
rami, has alveolar processes, two angles, condyles, and coro- 
noid processes. 

How are the bones of the cranium united? By sutures; 
they are the coronal, the sagital, the lambdoidal, and tho 
two squamous. In the lambdoidal are frequently found small 
bones called ossa wormiana, or triquetra, and occasionally 
these are found in the other sutures. The uses of the su- 
tures are not fully settled among anatomists and physi- 
ologists. 

What is the structure of the bones of the cranium ? They 
are composed of two tables united by cellular substance call- 
ed diploe which begins to show itself at two or three years 
of age. The internal table is thin and brittle and is called 
vitreous. 

How many bones enter into the composition of the orbit? 
Seven; the frontal, the malar, the superior maxillary, the 
planar plate of the ethmoid, the. ungui form, sphenoid, and 
palate. 

Where is the os hyoides situated? At the root of the 
tongue within the circle of the lower jaw and insulated, 
having no connection with any other bone except by mus- 
cles and ligaments. 



ANATOMY. 



19 



Superior Extremities. 

How are the superior extremities divided? They are 
divided on either side into shoulder, arm, fore-arm andhand^ 

What composes the shoulder? The clavicle and scapula, 
which occupy ;he superior, lateral, and posterior parts of 
the thorax. 

What are the characteristics of the scapula? It is on the 
posterior part of the thorax and extends from the second to 
seventh rib inclusive ; it is triangular, has an anterior face 
or venter and a posterior face or dorsum, a superior edge or 
costa, an external edge or inferior costa, and a posterior 

or internal edge termed the base ; has three angles 

one superior, one inferior, and the other anterior or ex- 
ternal; a spine running from the posterior edge obliquely 
towards the anterior angle, rapidly increasing until it rises 
and is elongated forwards and upwards and overhangs the 
shoulder joint, and is called the acromion process.; a cervix, 
coracoid process, and a glenoid cavity, for articulating with 
the humerus. 

What are the characteristics of the clavicle? It is along 



bone situated transversely at the superior and anterior parts 
of the chest, extending from the sternum to the acromion 
process of the scapula ; it is compared in shape to the letter f 
and is divided into body, sternal, and scapular extremities. 
What are the characteristics of the humerus? It is cyl- 



indrical, both extremities enlarged; the superior is called 
its head which is hemispherical, and attached to the body of 
the bone by the neck; it has two tuberosities, external and 
internal; two sigmoid cavities; one receives the coronoid 
and the other the olecranon process of the ulna; and two con- 
dyles. The part between the extremities is termed body. 
What are the bones of the fore-arm ? The ulna and radius. 
What are the characteristics of the ulna? It is situated 
on the inside of the fore-arm with the little finger ; nearly 
straight, much larger at the upper than at the lower extremi- 
ty; the upper or humeral extremity has an olecranon and a 
coronoid process, with the greater sigmoid cavity between 
them for articulating with the humerus, and the lesser on 
the radial surface of the coronoid for articulating with the 
head of the radius ; the lower extremity has a styloid pro- 
cess and an articular surface for articulating with the car- 
pus, and one for articulating with the radius. 



%0 



ANATOMY. 



What are the characteristics of the radius? It is shorter 
than the ulna, situated exteriorly to it and extends from the 
os humeri to the wrist; it is smaller at the upper than at the 
lower extremity. 

What composes the hand? The carpus, metacarpus and 
phalanges. 

What are the bones of the carpus? There are two rows : 
in the first are the scaphoides, lunare cuneiforme, and pisi- 
forme; in the second are the trapezium, trapozoides mag- 
num and unciforme. 

Where are the metacarpus situated? Between the car- 
pus and phalanges of the fingers and thumb, and are five in 
number. 

How many phalanges are there? Fourteen; three for 
each finger and two for the thumb; the bone adjoining the 
metacarpus is the first, the middle is the second, and the 
other the third. 

Inferior Extremities. 

What are the bones of each inferior extremity ? The os fe- 
moris, tibia, fibula, patella, tarsus, metatarsus and phalanges. 

What are the characteristics of the os femoris? It is the 
largest bone in the human body; at its superior extremity it 
has three well marked eminences, the head, and greater 
and lesser trochanters; the head is supported by the neck 
which projects from the body of the bone between the troch- 
anters; the line between the trochanters is called the linea 
quadrata. Its inferior extremity is larger and divided into 
two parts, the internal and external condyle. The linea as- 
pera begins broad, rough, and fiat, on a level with the troch- 
anter minor; as it descends it becomes more elevated, and its 
lower extremity divides into two superficial ridges, one run- 
ning to each condyle. 

What are the bones of the leg? The tibia, fibula, and 
patella. 

What are the characteristics of the tibia? It is on the 
internal side of the leg, and extends from the thigh to the 
foot; it is the longest and largest bone in the body, except 
the femoris; the superior extremity is much larger than the 
inferior; its inferior internal part is called the internal mal- 
leolus. 

What are the characteristics of the fibula? It is at the 



ANATOMY. 



external side of the tibia and extends from its head to the 
foot; its inferior and external part is called the external 
malleolus. The tibia and fibula articulate below with the 
astragalus. 

What are the characteristics of the patella? It is small, 
intermediate to the thigh and leg, and placed on the front of 
the knee joint; its anterior face convex and rough, and its 
circumference is nearly oval with the long diameter trans- 
verse. 

How is the foot divided? Into tarsus, metatarsus, and toes 
or phalanges. 

What composes the tarsus? Seven bones, viz; os calcis, 
the astragalus, the naviculare, the euboides, the cuneiforms 
externum, cuneiforme medium, and cuneiforme internum. 

Cartilage. 

What are the characteristics of cartilage? It is a sub- 
stance of a white or pearly color, hard, very elastic, found in 
various parts of the body, especially on the articular surfaces 
of bones, the end of the nose, the edges of the eyelids, the 
ear, wind pipe, end of ribs, &c. 

How are the cartilages divided? Into articular or those 
which cover the surface of bones in moveable joints; the in- 
terarticular or those which are interposed between the ends 
of bones to form a moveable socket; the connecting or those 



which unite the articular surfaces of bones by an immovea- 
ble union, as the sutures of the skull, the connexions be- 
tween the bones of the pelvis &c. ; and the cartilages of cav- 
ities or those which form the larynx, trachea, part of the 
nose, &c. 



What is the membrane surrounding cartilage called? 
Perichondrium, and it is similar to the periosteum. 

Of Ligaments. 

What are the characteristics of the ligamentous or des- 
moid tissue, called also fibrous tissue? It may be known by 
its whiteness, firmness, the unyielding nature of its materi- 
als, and its fibrous arrangement. It is very generally diffus- 
ed in the human body and has a v^ry close connection with 
the cellular texture; it also serves the purpose of connecting 
the bones in iheir articulations. The sensibility of this 

system is extremely obscure; the usual mechanical and 

o 



ANATOMY- 



chemical irritants do not affect it; it may, however, be pro- 
duced by a twisting motion, or when under a state of inflam- 
mation, as in gout, rheumatism, &c. 

What is meant by ligaments'? They are those organs 
which tie the bones together, and in the moveable joints are 
divided into the capsular, and the funicular. The first are 
open at the end and envelope the ends of the bones, extend- 
ing from one to the other; the second are mere cords, ex- 
tending from one bone to the other, and may be flattened, 
round or oval ; they may be either internal or external to 
the capsular ligament. 

What is meant by a synovial membrane? It is a mem 
brane lining each moveable articulation, reflected over the 
internal face of the capsular ligament and the articular car- 
tilages; it is a perfect sac, and differs from the capsular liga- 
ment in having no opening in it ; it is white, thin, semi- 
transparent and soft, belongs to the class of serous mem- 
branes, and the fluid secreted by it is called synovia, the use 
of which is to diminish friction, and facilitate motion. 

What enters into the articulation of the lower jaw? Be- 
sides the bones tiped with their cartilages there is a capsu- 
lar ligament, an internal, external, and styio-maxillary liga- 
ment, and a small triangular ligament discovered by Caldani, 
two synovial membranes, an interarticular cartilage and an 
erectile tissue. 

What are the ligaments of the vertebrae ? The interver- 
tebral, anterior and posterior vertebral, a capsular at the ar- 
ticulations of the oblique processes, interosseous, ligamen- 
turn nuchse, ligamentum rlava (23 pairs) ; between the occi- 
put and atlas is the anterior and posterior, between the sec- 
ond and first vertebra and the occiput are the lacerti liga- 
mentosi, transverse, oblique, or moderator, and middle or 
straight ligaments. 

What are the ligaments of the pelvis? The anterior and 
posterior coccygeal, ilio-lurnbar, sacro-spinous, sacro-iliac, 
posterior sacro-sciatic, anterior sacro-sciatic, obturator, an- 
terior pubic and the sub or inter-pubic ligaments. 

What are the ligaments at the posterior articulation of 
the ribs? The anterior or radiating, interarticular, two cap- 
sular for the head of each, and one where they are articulat- 
ed with the transverse processes of the vertebrae, the inter- 
nal transverse, the external transverse, and middle costo- 
transverse ligaments, 



ANATOMY. 



23 



What are the ligaments of the anterior articulation of the 
ribs ? There are two, an anterior, a posterior, and the costo- 
xiphoid ligaments; also a synovial membrane imperfectly 
developed. 

What is meant by the articulation of the shoulder? It is 
the junction of the clavicle to the upper part of the sternum 
and first rib; of the scapula to the clavicle; and of the hume- 
rus to the scapula. 

What are the ligaments and parts concerned in the articu- 
lations of the anterior end of the clavicle? The capsular 
and interclavicular ligaments; an interarticular cartilage; 
two synovial ™Z^^&iies ; and tie rnomboid ligament 
liecting the first rib with the clavicle. 

What ligaments are concerned in the scapuloclavicular 
articulations'? The capsular, the coraco-clavicular which is 
divided into the conoid and trapezoid, bifid, coracoid, and 
the triangular ligaments or eoraco-acromialis. 

What ligaments are concerned in the scapulo-humeral ar- 
ticulation? The capsular, the long head of the biceps, co- 
raco-humeral or ligamentum adscititum, and the glenoid 
ligament, which surrounds the glenoid cavity. 

What are the ligaments of the elbow joint? The cap- 
sular, annular, external and internal lateral ligaments. 

What ligaments are situated between the radius and 
ulna? The interosseous, the round ligaments and the 
capsular or sacciform at their lower extremities. 

What are the ligaments of the wrist joint? The internal 
and external lateral, capsular, dorsal, and palmar ligaments. 

What are the ligaments ef the ilio-femoral or hip articula- 
tion? The cotoloyd, which tips the margin of the acetabu- 
lum, the inter-articuiar or round, and the capsular ligaments. 

What are the ligaments of the knee joint? The capsu- 
lar ligament, or involucrum generale, the ligament of the 
patella, a posterior, internal and external lateral, and two 
crucial ligaments. This joint has also two semi-lunar 
cartilages. 

How are the tibia and fibula united together? They are 
united superiorly by an anterior and posterior ligament, and 
a synovial membrane. Inferiorly also by an anterior and 
posterior ligament; and the bodies of these bones are united 
by an interosseous ligament. 

What are the ligaments of the ankle joint? An imper- 
fect capsular, an internal and an external lateral ligament, 



Z4 



ANATOMY. 



What ligaments connect the os astragalus and os cal- 
cis? The interosseous, posterior, and deltoid ligaments. 

What connects the astragalus with the scaphoides? It is 
connected above by abroad thin ligament; below by two 
ligaments, internal and external ealcaneo-seaphoid. 

What connects the calcis with the cuboides? The su- 
perior and inferior calcaneo-cuboid ligaments* 

Of the Integuments. 

What is meant by the integuments of the body? The , 
cellular and adipose substances, and the dermoid covering. 

What are some of the properties of cellular tissue'? It is- 
an elementary tissue, generally disseminated over the whole 
body; found beneath the skin; between muscles; connect- 
ing membranes and other parts; entering into their compo- 
sition; indispensible to their texture; and precedes them in 
the development of the foetus. It is composed of cells which 
communicate freely with each other and may be distended 
either with air or other fluids, and from its elasticity 
when the distension is removed it will return to its original 
shape. 

Where is the adipose structure found? Between the 
skin and the fascia, in the layers of condensed cellular sub- 
stance, next to the muscles, as the face, neck, trunk of the 
body, buttocks, limbs, palms of the hands, soles of the feet, 
&lc. In chemical composition it differs from all other parts 
of the body in containing no nitrogen. It is enclosed by 
cellular substance. 

What is meant by the dermoid covering? The skin; its 
sebaceous organs; the nails; and the hair. 

How many lamina does the skin consist of ? Three;. the 
cutis vera, the retemueosum, and the cuticula. 

What is understood by the sebaceous organs? The folli- 
cles and glands which furnish the oily exhalation that lubri- 
cates the surface of the skin. 

What are the nails? They may be considered as a con- 
tinuation of the cuticle, supply its place on the extremities 
of the fingers and toes, and correspond with -the talons and 
hoofs of animals. They are devoid of organization. 

What are the hairs? They are cylindrical filaments 
found on most parts of the skin excepting the palms and 
soles. 



ANATOMY. 



2> 



Of Muscles. 

What are the properties of muscles ? They are the organs 
of motion, and are characterized by redness, softness, irri- 
tability, contractility, and by being formed of long, par- 
allel fibres, which are arranged into fasciculi; each fibre 
extending the whole length of the muscle, considering the 
length as represented by the tendinous beginning on one 
hand, and the tendinous termination on the other. 

How are they divided } Into voluntary and involuntary. 

What is meant by the myotility of muscles % It is their 
power of contraction, elongation, and remaining fixed. 

What does a muscle consist of?- A belly and two extre- 
mities; the one that is fixed is called the head or origin, and 
the other is the tail or insertion. The belly or body is the 
fleshy part, and the extremities are tendinous. In the most 
simple muscles, the fibres run in the direction of their length. 
Those which run obliquely from a tendon or bone are called 
semi-pennati. Those which converge obliquely to-a tendon 
in the centre are called pe-nnati. Others again are formed 
of a congeries of smaller muscles, the fibres of which run 
in different directions and intermixed with tendinous mat- 
ter, as the deltoid and subscapular. 

Upon what does the strength of a muscle depend ? Upon 
the number of its fibres; so that those whose fibres run ob- 
liquely are stronger than those which run longitudinally. 

How are tendons distinguished? By their white and 
shining appearance; they have no elasticity or power of 
elongation or contraction; they have two general shapes 
funicular or like cords ; and membraneous or resembling 
an aponeurosis. 

Truxe. 

• Abdomen. 
WTiat is tho origin, insertion, and use of the following 
muscles? 

Obliquus externus. Origin, eight or nine inferior ribs. 
Insertion, ensiform "cartilage, linea alba, pubis, Poupart's 
ligament, and anterior two-thirds of the crest of the ilium. 
Use, to compress the abdomen. 

Obliquus internus. Origin, fascia lumborum, crest of il- 
ium, and external third of Poupart's ligament. Insertion, in 
the cartilages of the seven inferior ribs, ensiform cartilage, 

3* 



ANATOMY. 



linoa alba, symphysis, and upper edge of the pubis. Use, to 
bend the body and compress the abdomen. 

Cremaster. Origin, Poupart's ligament and obliquus in- 
terims. Insertion, tunica vaginalis, testis,"* and scrotum. 

Transversalis. Origin, fascia lumborum, crest of ilium, 
Poupart's ligament, and seven lower ribs. Insertion with 
the obliquus internus. Use, to compress the abdomen. 

Rectus. Origin, pubis. Insertion, ensiform cartilage, and 
to the cartilages of the fifth and sixth ribs. Use, to bend 
the trunk, and compress the abdomsn. 

Pyrimidalis. Origin, pubis. Insertion, linea alba. 

Diaphragm. The greater muscle .Origin, xiphoid carti- 
lage, the cartilages of the last true and all the false ribs. 
Insertion, cordiform tendon. — The lesser muscle. Origin, 
the bodies of the four first lumbar vertebrae. Insertion, 
cordiform tendon. 

Quadratus lumborum. Origin, spine of ilium. Insertion, 
transverse processes of lumbar vertebrae, and last dorsal, 
Use, to bend the trunk to one side and forwards. 

Psoas muscles. Origin, the lumbar, and dorsal vertebrae. 
Insertion, cavity of the pelvis, and lesser trochanter. 

Iliacus internus. Origin, transverse process of last lumbar 
vertebra, crest of ilium, and iliac fossa. Insertion with the 
psoas muscles into the femur. Use, to bend the thigh 
and body. 

What are the muscles of the male perineum ? 
. Sphincter ani, externus and internus, erector penis, accel- 
erator urinae or ejaculator seminis, transversus perinei, leva- 
tor ani, compressor urethrae, and coccygeus. 

Bach. 

■ What is the origin, insertion, and use, of the following 
muscles? * 

Trapezius. Origin, occipital bone, ligamentum nuchae, 
last cervical, and the dorsal vertebrae. Insertion, clavicle, 
acromion process, spine of the scapula. Use, to draw the 
parts in the several directions of its fibres. 

Latissimus dorsi. Origin, dorsal spines, fascia lumborum, 
sacrum, ilium, and three or four last ribs. Insertion, hume- 
rus. Use, to draw the os humeri downwards, and back- 
wards. 

Rhomb oideus major and minor. Origin, ligamentum nu- 
chae, and dorsal spines. Insertion, base of the scapula. 
Use, to draw the scapula up and back. 



ANATOMY. 



07 



What other muscles are situated on the back ? Levator 
anguli scapulae, splenius capitis, and colli, sacrolumbalis, 
longissimus dorsi, spinalis dorsi, musculi accessorii, cervi- 
calis descendens, transversaiis cervicis, traehelo mastoideus, 
complexus, semi-spinalis colli and dorsi, muitifidus spinae, 
rectus capitus posticus major and minor, obliquus superior 
and inferior, interspinals, intertransversarii, and levatores 
costarum. 

Thorax, 

What is the origin, insertion, and use of the following 
muscles ? 

Pectoralis major. Origin, sternal half of clavicle, anterior 
surface of sternum, cartilages of the third, fourth, fifth, and 
sixth true ribs. Insertion, humerus, anterior edge of bicipi- 
tal groove. Use, to draw the arm inwards, forwards, and 
to depress it. 

Pectoralis minor. Origin, upper edge of fourth, fifth, and 
sixth ribs. Insertion, coracoid process of scapula. Use, to 
draw it in, and down. 

Subclavius. Origin, first rib. Insertion, clavicle. 

Serratus magnus. Origin, eight or nine superior ribs. 
Insertion, base of scapula. Use, to draw it forwards. 

Intercostales external. Origin, eleven inferior ribs at 
their external, inferior edges. Insertion, superior edge of 
ribs beneath. 

Internal. Origin, eleven ribs internally, from the lower 
edge of each. Insertion, inner lip of the rib beneath. Use, 
to draw the ribs together. 

Triangularis sterni. Origin, lower part of sternum. 
Insertion, cartilages of fourth, fifth and sixth ribs. Use, to 
diminish the cavity of the thorax. 

Neck. 

What is the origin, insertion, and use of the platisma 
myoides ? Origin, cellular membrane over deltoid and pec- 
toral muscles, and from the clavicle. Insertion, chin and 
fascia of the lateral and inferior parts of the face. Use, to 
elevate the skin of the neck. 

Sterno-cleido mastoideus. Origin, sternum and clavicle- 
Insertion mastoid process and transverse ridge of the occipi- 
tal bone. Use, to draw the chin towards the sternum. 

What other muscles are there of the neck, the names of 
which mostly indicate their attachment?- Stcrno-hyoideus, 



m 



ANATOMY. 



sterno-thyroideus, thyreo-hyoideus, omo-hyoideus, mylo-hy- 
oidcus, stylo-hyoideus, stylo-glossus, stylo-pharyngeus, ge- 
nio-hyoideus, longus colli, rectus capitis amicus major, mi- 
nor, and lateralis, scalenius anticus, medius and posticus. 

Head. 

Face. 

What is the origin, insertion and use of the occipito-fron- 
talis? Origin, superior transverse ridge of the eccipital 
bone and mastoid process. Insertion, integuments, and mus- 
cles of eyebrows. Use, to corrugate the forehead and ele- 
vate the supercilia. 

Corrugator supercilii. Origin, internal angular process of 
os frontis. Insertion, middle of eyebrow. Use, to draw tho 
lower part of the forehead into vertical wrinkles. 

"What are the other muscles of the face ? Compressor 
naris, orbicularis palpebrarum, levator labii superioris et alas 
nasi, levator anguli oris, zygomaticus major and minor, de- 
pressor labii superioris et alas nasi, depressor anguli oris, de- 
pressor labii inferioris, levator menti et labii inferioris, buc- 
cinator, orbicularis oris. 

Lower Jaw. 

Temporalis. Origin, semicircular ridge on parietal bone, 
temporal fossa, and fascia. Insertion, coronoid process of 
lower jaw. Use, to pull it directly up. 

Masseter. Origin, superior maxillary bone. Insertion, 
.outer surface of angle of lower jaw. 

Pterygoideus internus. Origin, internal side of external 
pterygoid plate. Insertion, inner side of angle of lower j aw. 
Use, to close the jaw and produce a grinding motion. 

Pterygoideus externus. Origin, outer side of external 
pterygoid plate. Insertion, internal part of neck of lower 
jaw. Use, same as former. 

Digastricus. Origin, groove at base of mastoid process. 
Insertion, inner side of base of jaw. Use, to open the mouth. 
Upper Extremity. 
Shoulder. 

What is the origin, insertion, and use of the following 
muscles.? 

Deltoides. Origin, lower edge of spine of scapula, acro- 
mion and outer third of clavicle. Insertion, humerus, near 
its middle. Use, to raise the arm. 

Supra spinatus. Origin, scapula above its spine. Inser- 



ANATOMY. 



29 



tion, great tuberosity of humerus. Use, to raise the arm 
and turn it out. 

Infra spinatus. Origin, scapula, below the spine. Inser- 
tion, great tuberosity of humerus. Use, to roll the arm. 

Teres minor. Origin, inferior costa. Insertion, great 
tuberosity of the humerus. Use, to rotate and draw tho arm 
down and back. 

Teres major. Origin, inferior angle uf scapula. Inser- 
tion, inner edge of bicipital groove. Use, to rotate tho arm 
inwards, and draw it back. 

Subscapularis. Origin, subscapular fossa. Insertion, small 
tubercle of humerus. Use, to draw the arm down and roll 
it In. 

Ann. 

Biceps. Origin, coracoid proc< 
ty. Insertion, tubercle of radii 
Coraco Brachialis. Origin, co 
ternal side of humerus near th 
arm up and forward. 

Brachialis internus. Origin, 
>id process of 



ge of glenoid cavi- 
0 flex the forearm, 
cess. Insertion, in- 
Use to draw the 



extensor cubiti. 



tits, gees 



a, outer 
f hume- 
forearm. 



side of humerus, ridge leading to internal com 
rus. Insertion, olecranon process. Usetoexten 

Fore Ann. 

What class of muscles take or 
dyle and anterior part of ulna? 

" What are the flexors and prom 
flexor carpi radialis, palmarus 1c 

Flexor digitorum sublimus pertoratus. (Jnpan inner con. 
dyle and radius. Insertion, second phalanx, °Use, to bend 
the second phalanx. 

Flexor digitorum profundus perforans. Origin, ulna, ra- 
dius, and interosseous ligament. Insertion, last^phalams 

Flexor longus policis. Origin, radius. Ii 
lanx of thumb. 

Pronator radii quadratus. Origin, anter: 
na. Insertion, anterior part of radius. 

What class of muscles take origin from the external con- 
dyle and posterior part of ulna ? The supinators and ex- 
tensors. 

What are the supinators and extensors? Supinator radii 



from the internal con- 
flexors and pronators, 
? Pronator radii teres. 
!. flexor carpi ulnaris. 



istpha 
;ertion, last pha- 

>r surface of ul- 



10 



ANATOI1Y. 



longus, extensor carpi radialis longior and brevior, extensor 

carpi u!nari3, extensor digitorum communis, supinator radii 
brevis, extensor ossis metaearpi pollicis manus, extensor mi- 
nor pollici? manus, major pollicis manus, and indicator. 

Inferior Extremity. 
Thigh. 

What is the origin, insertion, and use of the following 

muscles'? 

Tensor vaginae femoris. Origin, ilium. Insertion, fascia 
lata. 

Sartorius. Origin, anterior superior spinous process Gf 
ilium. Insertion, upper end of tibia. Use, to bend the leg 
and draw it obliquely in. 

Rectus femoris. Origin^ anterior inferior spinous process 
and margin of acetabulum. Insertion, patella. 

Vastus externus. Origin, below trochanter major and 
outer edge of linea aspira. Insertion, unites with rectus. 

Vastus internus. Origin, on a level with trochanter minor 
and from inner edge of linea aspira. Insertion, unites with 
rectus. 

Cruraeus. Origin, anterior and external part of femoris. 
Insertion, unites with rectus. Use of these four to extend 
the leg. 

Gracilis. Origin, symphysis and descending ramus of 
the pubis. Insertion, internal surface of tibia. Use, to flex 
the leg. 

Pectineus. Origin, horizontal portion of pubis. Inser- 
tion, upper part of linea aspera. Use, to draw the thigh in- 
wards and forwards. 

Adductor longus. Origin, anterior surface of pubis. In- 
sertion, middle third of linea aspera. 

Adductor brevis. Origin, anterior inferior surface of pu- 
bis. Insertion, superior third of linea aspera. 

Adductor magnus. Origin, descending ramus of pubis, 
ramus and tuberosity of the ischium. Insertion, internal 
condyle and ridge leading to linea aspera. Use, these three 
muscles draw the thigh inwards. 

Gluteus maximus. Origin, posterior third of spine of ili- 
um, sacrum, os coccygis, and sacro sciatic ligament. Inser- 
tion, between trochanter and linea aspera, linea aspera and 
fascia lata. Use, to draw the thigh back and keep the tmnk 
erect. 



ANATOMY. 



3; 



Gluteus medius. Origin, spine of ilium and dorsum. In- 
sertion, great trochanter. Use, to draw the thigh back and 
out. 

Gluteus minimus. Origin, dorsum of ilium. Insertion, 
great trochanter. Use, to abduct the thigh and rotate the 
iimb inwards. 

Pyriformi-s. Origin, sacrum, sciatic ligament, and ilium. 
Insertion, root of trochanter major. Use, to rotate the 
limb in. 

Gemini. Origin, one from root of the spine of ischium, 
the other from tuberosity. Insertion, root of trochanter ma- 
jor. Use, to rotate the limb in. 

Obturator internus. Origin, pelvic margin of foramen thy- 
roideum, its membrane and piano of the ischium. Inser- 
tion, fossa of trochanter. Use, to rotate the limb out. 

Quadratus femoris. Origin, tuber ischii. Insertion, great 
trochanter and line leading to the lesser. Use to rotate the 
limb out. 

Obturator externus. Origin, obturator ligament. Inser- 
tion, fossa at root of trochanter. Use, to rotate the thigh out. 

Biceps flexor cruris. Origin, longhead, tuber ischii; short 
head, linea aspera low down. Insertion, head of fibula. 
Use, to ilex the leg. 

Semi-tendinosus. Origin, tuber ischii. Insertion, tibia. 
Use, to flex the leg. 

Semi-membrancsns. Origin, tuber ischii. Insertion, ex- 
ternal condyle of femur, and heads of tibia and fibula. Use, 
to flex the leg. 

Leg. 

Tibialis amicus. Origin, head and spine of tibia, interosse- 
ous ligament. Insertion, great cuneiform bone and first me- 
tatarsal. Use to present the sole obliquely in. 

Extensor longus digitorum pedis. Origin, heads of tibia 
fibula, and interosseous ligament. Insertion, last phalanx of 
the four external toes. Use, to extend the toes. 

Peroneus tertius. Origin, fibula. Insertion, metatarsal 
bone of little toe. Use, to bend the foot. 

Extensor proprius pollicis pedis. Origin, middle third 
of fibula and tibia. Insertion, second phalanx of great toe. 
Use, to extend it. 

Peroneus longus. Origin, head of fibula and tibia, in- 
sertion, metatarsal bone of great toe and internal cuneiform. 
Use, to extend the foot and incline the sole outwards. 



ANATOMY. 



Peroneus brevis. Origin, lower half of fibula. Insertion, 

base of metatarsal bone of little toe and cuboid bone. 

Gastrocnemius. Origin, upper and back part of condyle 
of femur and ridge above it. Insertion, os calcis. 

Soleus. Origin, external head from superior third of fibu- 
la; internal head, middle third of tibia, unites with the above 
and forms the tendo-Ackillis. Insertion, os calcis Use, 
to extend the foot. 

Plantaris. Origin, back part of femur. Insertion, os calcis. 

Popliteus. Origin, depression on outer condyle. Inser- 
tion, upper part of tibia. 

Flexor longus digitorum pedis perforans. Origin, flat sur- 
face of tibia, fascia, &c. Insertion, last phalanx of four les- 
ser toes. 

Flexor longus pollicis pedis. Origin, inferior part of fibu- 
la. Insertion, last phalanx of great toe. 

Tibialis posticus. Origin, tibia, fibula, and ligament. In- 
sertion, os naviculare. Use, to extend the foot, and present 
the sole inwards. 

Organs of Digestion. 

What are the organs of digestion? The organs of diges- 
tion consist in an uninterrupted canal extending from the 
lips to the anus, and of numerous glandular bodies placed 
along its course. This canal, called aiimentaty, is divided 
into three portions, the superior, middle and inferior. The 
superior is composed of the mouth, pharynx, and oesophagus; 
the middle of the stomach and small intestine; the inferior 
of the large intestine. The glandular bodies are the salivary 
glands, pancreas, liver, spleen, and a large number of muci- 
parous glands extending along the whole course of the canal. 

Teeth. 

What are the characteristics of the teeth? They are the 
hardest portions of the body, bear an analogy to bone. The 
greater part of their length is implanted into the alveolar 
processes of the jaws; this part is called the root; beyond 
this is a portion embraced by the gum called, the neck; and 
the free. or projecting part is the body or corona. 

What is the number of teeth in the adult? Thirty-two; 
sixteen in each jaw, and axe classified from their shape into 
eight incisors, four cuspated, eight bi-cuspated, and twolve 
molar. 



ANATOMY. 



33 



Of what are teeth composed ] They are composed of two 
substances, one, of which, is ivory, or bone like, and the oth- 
er enamel. The enamel forms the periphery of the body of 
a tooth, as is known by its whiteness, brittleness, semi-trans- 
parency and hardness! It is fibrous and the fibres are plac- 
ed so as to pass from the surface towards the centre of the 
tooth, so that the friction is applied against their extremi- 
ties. Its composition is principally phosphate of lime with 
a small portion of gelatin. The osseous portion is the most 
abundant; it forms the root, neck, and body, except the 
crust of enamel on its periphery. Internally there is a cavi- 
ty filled with a soft pulpy matter which" receives an artery, 
a vein, and a nerve. 

The arteries of the teeth of the upper' jaw come from the 
alveolar and infra orbitar; and the nerves from the second 
branch of the fifth pair; the arteries of the lower tooth 
come from internal maxillary, and the nerves from the third 
branch of the fifth pair. 

What is understood by deciduous teeth? They are teeth 
peculiar to infants, and are twenty in number, ten in each 
jaw; on either side are two incisors, one cusoidatus, and 
two molares. Some of them fall out about the seventh year 
and all of them by the fourteenth. The order of their ap- 
pearance is as follows : — 

Two central incisors, from the sixth to the eighth month. 

Two lateral incisors, from the seventh to the tenth month. 

The first molar on each side, from the twelfth to the four- 
teenth month. 

The cuspated", from the fifteenth to the twentieth month. 
The second molar, from the twentieth to the thirtieth 
month. 

At birth there are the rudiments of fifty-two teeth in the" 
two jaws; twenty deciduous and thirty-two permanent 

How are the deciduous teeth removed? By the absorp- 
tion of the roots. 

Tongue. 

Where is the tongue situated? It extends from the os 
hyoides posteriorly to the incisor teeth anteriorly. It is di- 
vided into base, body, and tip. 

What muscles compose the tongue ? The stylo-r/lossus 
hyo-glossus, genio-hyo-glossus and lingualis form the prin- 
cipal bulk; besides these there are the superficial lingual 
4 



ANATOMY. 



muscle, transverse lingual muscles, and the vertical Ungual 
muscles, which are small fibres running in different direc- 
tions as their names indicate, 

How are the papillae of the tongue divided? Into papillae 
maxima? or capitatae, mediae, villos&e, and filiformes: and 
occupy the anterior two thirds of this organ. 

The tongue is supplied with arteries principally from the 
lingual branch of the carotid; and with nerves from the hy- 
po-glossal, the fifth pair, and the glosso-pharyngeah 

Palate* 

What composes the palate? It is composed anteriorly by 
the palatine processes of the superior maxillary and pala- 
tine bones, covered by the lining membrane of the mouth 
below, and pituitary membrane above; posteriorly is a mem- 
branous portion called the soft palate, which has an oblong- 
shape and continued from the hard palate posteriorly; in its 
centre is the uvula from which proceeds the two crescentric 
doublings called the lateral half arches which are divided 
into anterior and posterior. In the depressions between 4 
these is the tonsil gland. The space bounded in front, and 
behind, by these lateral half arches is the fauces ; and the an- 
terior opening into it is- the isthmus of the fauces. 

The muscles of the palate are the constrictor isthml fau- 
cium, palato-pharyngeus, circumflexus, or tensor palati, le- 
vator palati r and azygos uvula. 

Glands. 

How are the glands of the mouth divided) Into mucipa- 
rous and salivary. 

What are the muciparous glands ? They are the labial 
buccal, lingual, palatine, and the tonsils. 

What are the salivary glands? The parotid, its excreto- 
ry duct is called the duct of Steno; it is the size of a crow 
quill, and opens opposite to the second large molar tooth of 
the upper jaw ; the submaxillary, its duct is called the duct 
of Wharton; and the sublingual, its duct is called ductus 
Riviniani. 

Pharynx. 

What are the characteristics of the pharynx ? It is a large 
membranous cavity, situated between the cervical vertebrae 
and posterior part of the nose and mouth, and extends from 



ANATOMY. 



the base of the cranium to the lower par* of the cricoid car- 
tilage, and fifth cervical vertebra, where it is continued into 
the'oesophagus. It consists of three coats; the external or 
muscular, is composed of three muscles on each side, one 
above the other, — a cellular, intermediate; and an internal, 
or mucous coat. The muscles forming the muscular coat 
are the constrictors inferior, medius, and superior. The ar- 
teries which supply it, are the superior, and inferior pharyn- 
geal on each side. 

What are the characteristics of the oesophagus? It is a 
tube continuous with the pharynx, in front of the spine, be- 
hind the trachea, ten or twelve lines in diameter, and in- 
creases in size from above downwards. In the thorax it 
passes down in the posterior mediastinum, with the aorta 
on the left, and the vena azygos on the right. It has three 
•coats, the muscular, cellular, and mucous, and is united to 
adjacent parts by loose cellular substance. The mmseular 
coat consists of two lamina, the longitudinal and the circular. 
Its arteries are derived from the inferior thyroid the thoracic 
aorta, and the gastric. 

Abdomen. 

How is the abdomen bounded? Inferiorly by the iliaci 
interni, the psoae, and levator ani muscles; on the front and 
sides by the five pairs of abdominal muscles, posteriorly by 
the lesser muscle of the diaphragm, quadrati lumborum, the 
lumbar vertebrae, and the sacrum. 

How many kinds of viscera are contained in the cavity of 
the abdomen? Three: one is engaged in digestion and as- 
similation, another in the secretion and excretion of wrine, 
and the third in generation. 

How is the abdomen divided? late a-rbitrajry regions: 
eonsider a line or plane as extending across the abdomen 
about two inches below the umbilicus from the superior 
part of the crista of one ilium to the corresponding point of 
the other side. Draw on each side a line perpendicular to 
the first by commencing at the anterior inferior spinous pro- 
cess of the ilium, and carry it up to the diaphragm ; then ex- 
tend a fourth line across the abdomen parallel with the first 
and intersecting the two last where they strike the cartilages 
fif the ri<bs. It is seen that these four lines or planes, with 
the assistance of the parieties of the abdomen, furnish nine 
regions. The central one above is called the epigastric* 



3G 



ANATOMY. 



and the lateral the right and left hypochondriac. The ccn* 
tral in the middle is the umbilical, and the lateral, the right 
and left lumbar. The central below is the hypogastric, and 
the lateral the right and left iliac. The scrobiculus cordis, 
or pit of the stomach, is the hollow in the epigastric region. 
The regio pubis is the region for two inches around the sym- 
phisis pubis. These two last are termed subordinate divi- 
sions. 

What position relative to these regions does the liver oc- 
cup}^? Nearly the whole of the right hypochondriac; the 
upper half of the epigastric; and the right superior part of 
the left hypochondriac. 

Where is the spleen situated ? In the posterior part of the 
left hypochondriac region. 

Where is the stomach situated ? Moderately distended 
it occupies the lower half of the epigastric region and the 
right inferior portion of the left hypochondriac. 

Where is the small intestine situated ? Moderately dis- 
tended by flatus, it occupies the umbilical region, the hypo- 
gastric, portions of the iliac on each side, and also the upper 
part of the cavity of the pelvis, when its viscera are empty. ' 

W T here is the large intestine situated? It begins in the 
right iliac region, ascends through the right lumbar and 
right hypochondriac, passes into the lower part of the epi- 
gastric, or upper part of the umbilical, according to the state 
of distension of the stGmach, thence into the left hypochon- 
driac, left lumbar, and left iliac, passes into the pelvis, and 
descending in front of the sacrum, terminates in the anus. 

Where is the pancreas situated? Transversely in the 
lower back part of the epigastric region, extending from the 
left hypochondriac to the right side of the spine, and is 
placed behind the stomach which covers it. 

Where are the kidneys, and capsulae renales situated? In 
the posterior part of the lumbar regions on each side of the 
spine. 

Where are the urinary bladder, and rectum situated? In 
the cavity of the pelvis, and between them in the female is 
the uterus, ovaries, and vagina. 

"What is understood by the peritoneum? It is a serous 
membrane lining the abdomen and reflected over the peri- 
phery of nearly all the viscera. It is a complete sac, with 
no opening into it, except in the female through the fallopian 
tubes. 



ANATOMY. 



3* 



What are the processes of the peritoneum? There are- 
four, and are known by the general name of omentum, epi- 
ploon, or caul. They are called omentum minus or hepati- 
co gastricum, omentum majus or gastro colicum, omentum 
colicum, and the omentum gastro-splenicum. 

What are the characteristics of serous membranes? They 
are thin, transparent, and white, resemble compressed cel- 
lular membrane, invariably assume the form of perfect sacs; 
are distinct one from another, and secrete a serous fluid for 
the lubrication of their internal surfaces. 

Chlypoietic Viscera. 

Stomach. 

What are the characteristics of the stomach'? It is a 
hollow viscus, situated in the epigastric region, of a conoidal 
shape, curved upwards, and presents two faces, two orifices, 
two curvatures, and two extremities. The faces are called 
anterior and posterior. The orifices are named cardiac and 
pyloric. The curvatures are the great and small, or upper 
and lower. It has four coats or laminae, viz : peritoneal, 
muscular, cellular, and mucous. Its muscular coat is col- 
lected into fasciculi, and pass in three directions, longitu- 
dinal, circular, and oblique. The glands of Brunner are 
situated near the cardiac and pyloric orifices. It is very 
vascular; its arteries being branches of the coelic, are tho 
gastric, right and left gastro epiploic, and the vasa brevia. 
The first to the lesser curvature ; the second and third along 
the great curvature; and the last, from four to six in number, 
to its great cul-de-sac. The veins terminate in the vena 
portarum. Its nerves come from the par vagurn, and tho 
semilunar ganglion of the sympathetic. 

Intestines. 

What is the length of the intestinal canal from the pylorus 
to the anus? From thirty to thirty-five feet; and is divided 
by anatomists into the small, and large intestine. 

What are the characteristics ef the small intestine? It 
commences at the pylorus and terminates in the right iliac 
region by a lateral aperture j.n the large intestine. It is 
four-fifths of tho length of the whole canal being from 
twenty-four to twenty-eight feet, cylindrical; the upper end 
is larger than the lower, decreasing gradually as you pro- 
ceed downwards. It has four coats like the stomach, which 

4* 



38 



ANATOMY. 



have the same names. The course of its muscular fibres are 
longitudinal and circular. Its mucous coat is thrown into 
folds or duplicatures, called valvules conniventes, in the di- 
rection of the circumference, and are segments of circles. 

On this coat are numerous small projections, called villi, 
hence it is sometimes termed villous coat. Each villus is com- 
posed of an artery, vein, and lymphatic. Its mucous glands 
are situated in the cellular coat, between the muscular and 
mucous, and their ducts open on the surface of the latter. 
They are solitary and aggregated; the former are glandulae 
solitaries or Brunneri, and are found principally in the duo- 
denum, and upper portion of the small intestine; the latter 
are called glandulse agmihatse or Peyeri, and exist in the 
lower part of the small intestine. 

How is the small intestine divided? Into duodenum, je- 
junum, and ileum; the latter two have no mark of distinc- 
tion, and are sometimes called the mesenteric portion, The 
duodenum is about twelve inches long, and is the com- 
mencement of this canal. The upper two-fifths below the 
duodenum, is called the jejunum, and the lower three-fifths 
the ileum. 

What is the mesentery? It is a process of peritoneum 
which servos to connect the small intestines to the posterior 
parietes of the abdomen, and extends from the left side of 
the second lumbar vertebra to the right iliac fossa; this at- 
tachment is called the root, and is about six inches long. Its 
lamina contains the superior mesenteric artery and vein,' 
lymphatic or lacteal glands and vessels, ramifications, from 
the solar plexus of the sympathetic nerves, and cellular, 
and adipose tissue. 

What are the characteristics of the large intestine.? It 
exceeds in diameter the small, and receives the effete matter 
therefrom. It is not so regularly cylindrical, the surface is 
arranged into three series or longitudinal rows of projec- 
tions, separated by transverse depressions. It commences at 
the inferior end of the small intestine, and terminates at the 
anus. It is divided into three parts ; the commencement, 
below the insertion of the ileum, about two inches in length, 
is called the ccecum, or caput coli; the remaining portion, 
until it reaches the pelvis, is called the colon, when it takes 
the name of rectum. 

What is meant by mesocolon? A duplication of pcrito- 



ANATOMY. 



neum, which fixes the large intestine to the- posterior parie- 
ties of the abdomen. 

How many coats has the large intestine? Four; bearing 
the same name as those of the small intestine. The perito- 
neal coat has small duplicatures containing fat, and called 
appendices epiploic® >; the muscular coat has two layers of 
fibres, the longitudinal, and transverse or circular; the mu- 
cous coat has but few villi, but its muciparous glands and 
follicles are very numerous. 

Where is the ileo-colic valve? At the junction of the 
ileum and caput coli or coecum. 

What is meant by mesorectum? It is that duplicature of 
peritoneum which attaches the rectum to the sacrum. 

From what is the large intestine supplied with blood ? 
A part of the superior mesenteric, the whole of the inferior 
mesenteric, and the internal pudic arteries; the veins empty 
into the vena portarum; the nerves are derived from the so- 
lar and hypogastric plexus of the sympathetic. 

What are the characteristics of mucous membranes? 
They line the internal surfaces of the hollow viscera, and 
form an internal tegument to the body, analagous to the 
skin. They are of a soft, spongy consistence ; easily yield 
to mechanical violence, and are dependent upon the sur- 
rounding cellular coat for their strength. 

Assistant Chylopoietic Viscera.. 

What arc the characteristics of the liver? It secretes the 
bile, and is the largest gland in the human body. Its whole 
superior face is in contact with the diaphragm, on the left 
is the spleen, below are the stomach and transverse colon, 
and behind are the vertebras and ascending cava. It is about 
ten inches in length, six or seven wide, and weighs in the 
adult four to five pounds. It is divided into lobes, called 
right and left. The former is the larger, and has ele- 
vations on its surface, called lobulus spigelii, and lobulus 
quartus. 

What are the ligaments of the liver? The falciform or 
suspensory, the ligamentum teres, the right lateral, the loft 
lateral, and some anatomists give the name of coronary to 
that duplicature of peritoneum, at the junction of tho sus- 
pensory and lateral ligaments. The liver has also a proper 
coat connecting it with the peritoneum. 



40 



ANATOMY, 



What are the bloodvessels) They are of three kinds r 
the vena portarum, the hepatic artery, and the hepatic 
veins. 

What composes it? Acini, or granulations, each of 
which is complete in itself, having the above named blood 
vessels, the origin of a branch of the hepatic duct, called 
porus biliarius, lymphatic vessels, and nerves. 

What is the capsule of Glisson? It is a condensed cellu- 
lar fibrous tissue, at the bottom of the transverse fissure of 
the liver, which invests the vena portarum, hepatic artery, 
and biliary ducts, and follows them throughout the sub- 
stance of the liver. 

What are the characteristics of the gall bladder? It is a 
reservoir for the bilo, fixed on the under surface of the great 
lobe of the liver, to the right of the umbilical fissure; its 
shape is an oblong pyriform sac. It has three coats, a peri- 
toneal, a cellular, and a mucous. Its artery is a branch 
of the hepatic; its veins empty into the vena portarum, and 
its nerves come from the sympathetic. Its duct, called cys- 
tic, unites at an acute angle with the hepatic duct, and 
forms the ductus communus choledochus ; these ducts have 
two coats, an external, fibrous lamellated and extensible, 
and a mucous. 

What are the characteristics of the spleen ? It is in the pos- 
terior part of the left hypochondriac region, bounded above 
by the diaphragm, below by the colon, on the right by the 
great end of the stomach, and the pancreas. Its color varies 
from deep blue to dark brown; it is usually about four and 
a half inches long by two and a half wide. Its artery call- 
ed splenic, is a branch of the ceelic, its vein empties into 
the vena portarum, and its nerves are derived from the so- 
lar plexus. It has no excretory duct, and its use is not as- 
certained. 

What are the characteristics of the pancreas? It is fixed 
in the lower and back part of the epigastric region ; bound- 
ed in front by the stomach which conceals it, and is be- 
tween the two laminae of the mesocolon, about six or seven 
inches long, two wide, and flattened before and behind; its 
right extremity is enlarged into a head or tuber, sometimes 
called the lesser pancreas. It is of a light grey, or pink co- 
lor, and consists of lobules. The arteries which supply it, 
come principally from the splenic; the veins empty into the 
splenic; and the nerves come from the solar plexus. It 



ANATOMY. 



41 



secretes a salivary fluid and is the largest of this class of 
glands. Its excretory duct is called ductus Wirsungii, which 
either penetrates the ductus communus choledochus, or the 
duodenum, very close to it. 

Urinary Organs. 

What are the urinary organs? The kidneys, renal cap- 
sules, bladder, and urethra. 

What are the characteristics of the kidneys? They are 
two glandular bodies for the secretion of urine, situated on 
cither side of the spine, extending from the tipper margin 
of the eleventh dorsal to the lower margin of the second 
lumbar vertebra; the right is ten or twelve lines lower than 
the left, they are hard, solid, of a brown color, a compress- 
ed ovoidal shape, excavated on the margin, which is ap- 
plied to the spine, and resemble the common kidney bean; 
they are about four inches long, and tw T o wide, and weigh 
each three or four ounces, have no peritoneal coat, but have 
a well marked capsule; the arteries are called the renal or 
emulgent and are branches of the aorta ; the veins take the 
same name as the arteries, and are equal to them in num- 
ber. The substance cf the kidneys is divided into cortical, 
and medullary, or tubular. 

The cortical, or secretory substance forms the circumfer- 
ence, and is on an average about two lines in thickness. 

The tubular portion consists in from twelve to eighteen 
conoidal fasciculi called the pyramids of Malpighi, with their 
bases towards the cortical portion; their apices converge to- 
wards the centre, are free, and project so as to form the pa- 
pilla? renalcs. Each fasciculi or cone, is composed of acoU 
lection of tubes, called tubuli uriniferi. 

What composes the excretory duct of the kidney? The 
ureter, which commences in the centre of the kidney, by an 
enlargement called pelvis; this branches off superioriy, into 
three or four portions called calices, one above, one below, 
and one or two intermediate. Each of these calices is divi* 
ded at its free extremity into three or four short funnel 
shaped terminations, called infundibula. These terminal 
tlons embrace each by its expanded orifice, the base of a pa* 
piila, so as to permit the latter to project into it, and distil 
its urine there. The pelvis of the kidney as it emerges from 
the fissure becomes reduced to a cylindrical canal, which is 
properly the ureter; it is about the size of a goose quill* 



■n 



ANATOMY, 



descends into the pelvis, and penetrates obliquely the coats 
of the bladder, ten or twelve lines behind its neck, and is 
composed of two coats or lamina. 

What are the renal capsules? They are two small bodies, 
one on either side, placed upon the upper end of the kid- 
ney, of a yellowish brown color tinged with red, have no 
excretory ducts, and are the most distinctly developed in 
the foetus. 

What are the characteristics of the bladder? It is the 
reservoir for the urine, placed in the pelvis just behind the 
symphysis of the pubes. The superior end is called the 
upper fundus; the lower end the inferior fundus; and be- 
tween the two is the body; the neck is its place of junction 
with the urethra. It consists of four coats; the peritoneal, 
muscular, cellular, and mucous. The internal face of the 
mucous coat presents at its inferior part the vesical triangle, 
behind and below the neck, occupying the space between 
it and the orifices of the ureters. The uvula vesicas is at the 
anterior angle of the triangle, which sometimes presents an 
obstruction to the introduction of the catheter. 

Organs of Generation in the Male, 
What does the male organs of generation consist of ? The 
testicles, and th6 penis, with their appendages. 

How is the penis formed? By common integuments, eel 
lular tissue, the corpora cavernosa, and the corpus spongio- 
sum urethrae. 

What are the characteristics of the urethra? It is a canal 
whose length varies, and extends from the neck of the blad* 
der to the extremity of the glans penis. The first part pen* 
etrates the prostate gland, and is called the prostatic portion, 
on its inferior surface is a doubling, which constitutes the 
yerumontanum or caput gallinaginis. Between the prostate 
and the bulb is the membranous portion, about eight or ton 
lines long; this canal varies in its dimensions indifferent 
parts. 

What are the characteristics of the vesipula seminalis? 
They are two convoluted tubes, one on each side, two inches 
in length, placed on the lower fundus of the bladder between 
it and the rectum, and behind the prostate gland; they are 
composed of two coats. The excretory duct of each vesicle 
is about a line and a half long, when it joins with the vas 
deferens of the same side; a common canal is formed called 



ANATOMY; 



43 



ductus ejaculatorius, which is eight or ten lines long, runs 
parallel with its fellow, and opens at the lateral anterior 
face of the caput gallinaginis. 

What are the characteristics of the prostate gland ? It is 
a body about the size of a horse-chestnut, fixed on the neck 
of the bladder, and penetrated by the urethra. 

What is the situation of Cowper's glands? They are two 
in number, one on each side, situated in advance of the pros- 
tate, between the laminae of the triangular ligament. 

What are the characteristics or the testicles ? They are 
two in number, one on each side of the scrotum, of an ob- 
long form, compressed laterally, an inch and a half long, 
one inch in breadth, eight or ten lines in thickness, and en- 
veloped by the scrotum, dartos, tunica vaginalis, and tunica 
albuginea. 

The scrotum is a continuation of the common skin, com- 
mon to both testicles, symmetrical, and divided by a middle 
line, called raphe. 

The dartos is within the scrotum, and forme two sacs, one 
for each testicle. 

The tunica vaginalis is rigidly comparable to a doublo 
night-cap, one portion adhering firmly to the tunica albu- 
ginea beneath, and the other loosely reflected over the tes- 
ticle. 

The tunica albuginea is the proper coat of the testicle, 
and is in immediate contact with it; it is dense, strong, 
white, and fibrous. 

The glandular portion of the testicles consist of a conge- 
ries of convoluted tubes called tubuli seminiferi, amounting 
to three hundred in number, and each nearly seventeen and 
a half feet in length, forming hanks held together by cellular- 
substance. 

The vasa recta are terminations of the tubuli seminiferi, 
which unite near the centre of the testicle in a complicated 
arrangement, called rete vasculosum testis 

The vasa efferentia, (from twelve to eighteen ducts,) pro- 
ceed from the reto vasculosum testis, and penetrate the cor- 
pus highmorianum and tunica albuginea. Each one is then 
convoluted upon itself into a conical body, the conus vascu- 
losus. Each cone, at its base, has its tube entering succes- 
sively into the tube of which the epididymis is formed. 

The epididymis is formed of a single convoluted tube of 
the fourth of a line in diameter: at the lower end it becomes. 



ANATOMY-. 



less convoluted, turns upwards, and obtains the name of vas 
deferens. 

What forms the spermatic cord? It is a fasciculus of 
about half an inch in diameter, and may be felt passing from 
the upper end of the testicle to the abdominal ring. It is 
formed by the vas deferens, spermatic artery, and veins, 
lymphatics of- the testicle, and the nerves; covered by a cel- 
lular substance called tunica vaginalis communis, and the 
cremaster muscle. 

The cremaster muscle is derived from the internal oblique 
and transversalis, completely envelopes the chord and draws 
the testicle upwards. The vas deferens is the proper excre- 
tory duct of the testicle, it is a white tube, about a line and 
a half in diameter, and has a cartilaginous feel; from the 
internal abdominal ring, it dips down into the pelvis by the 
-side of the bladder, and terminates in the urethra, after uni- 
ting with the duct from the vesicula seminalis ; this common 
duct is called the ductus ejaculatorius. 

Yv^iat are the fe,sciee and muscles of the perineum'? Pe- 
rineal fascia, the triangular ligament of the urethra, and the 
pelvic fascia. The muscles are the erector penis, accelera- 
tor urinae, transversus perinei, sphincter ani, coccygeus, and 
levator ani. 

Female Organs of Generation, 

What are the organs of generation in the female? The 
vulva, vagina, uterus, and the ovaria. 

What constitutes the vulva? The vulva consists in the 
mens veneris, the labia externa, the labia interna, the clito- 
ris, the vestibulum, the oriricum urethra), the fourehette, 
and the fossa navicularis. 

What are the characteristics of the vagina? It is a thin 
membranous canal, leading from the vulva to the uterus, 
from four to six inches in length, between the bladder in 
front and the rectum behind, flattened, so as to bring its an 
tenor and posterior surfaces in contact, has two tunics, a fi- 
brous, and a mucous. At its anterior end is the corpus 
spongiosum vaginae, or plexus retiformis. The sphincter va- 
gina muscle surrounds its anterior orifice. 

The hymen is placed at the anterior orifice, for the pur- 
pose of closing it more or less perfectly. 

What are the characteristics of the uterus? It is a com- 
pressed pyriform body, wo and a half inches long, and one 



ANATOMY. 



45 



and a half in diameter at its widest part. Its posterior face 
convex, anterior nearly flat, about one inch in thick- 
ness, and divided into fundus, body, and neck. The fundus 
is the part between the fallopian tubes at the superior extre- 
mity, the neck is the lower cylindrical portion, and the 
body is the- part intermediate to the two. Its cavity is tri- 
angular, with the sides convex, and the inferior angle pre- 
sents towards the opening into the vagina, called os tincae. 
The mucous glands or lacunae, in the neck, are called ovu- 
la Nabothi. Its structure is composed of longitudinal, cir- 
cular, and oblique fibres. 

What are the ligaments of the uterus? The broad or 
lateral, the anterior, the posterior, and round ligaments. 

What are the Fallopian tubes ? They are two membra- 
nous canals, one on each side, in the superior part of the 
broad ligaments of the uterus, four inches long, extend from 
the upper angle of the uterine cavity to the side cf the pel- 
vis, where their extremities are loose and expanded into a 
trumpet shaped mouth. 

What are the characteristics of the ovaries ? They are 
two in number, one on each side, situated on the posterior 
face of the broad ligament, of a compressed ovoid shape, 
about half the size of the male testicle. They have two 
coats, a peritoneal, and the tunica albuginea, which cor- 
responds with the same coat of the testicle. 

From whence do the female organs of generation derive 
their blood vessels and nerves? Principally from the internal 
pudic and other branches of the hypogastric arteries; their 
veins run into the hypogastric; and their nerves come from 
the sacral, and hypogastric plexuses. 

Organs of Respiration. 

What are the organs of respiration? The larynx, tra- 
chea, and lungs. 

Larynx. 

What are the characteristics of the larynx? It is an ir- 
regular cartilaginous tube, forming the upper part of the 
wind pip'e ; it is below the os Iiyoides and root of the tongue, 
bounded behind by the pharynx, and laterally by the primi- 
tive carotid arteries and internal jugular veins, and contri- 
butes essentially to the formation of the voice. 

Five distinct cartilages enter into its structure; they are 
one thyroid, one cricoid, k one epiglottis, and two arytenoid. 



46 



ANATOMY. 



The thyroid is the largest, and forms the prominence in 
the upper part of the neck, called pomum Adami. It has 
two processes on each side; one called cornu majus and the 
other cornu minus. 

The cricoid is below the thyroid, forms the base of the 
larynx, and articulates with the trachea. 

The arytenoid cartilages resemble triangular pyramids 
Curved backwards, are about six lines long, and are placed 
on the upper margin of the cricoid cartilage behind. 

The epiglottis is situated on the posterior face of the base 
¥>f the oshyoides; its general shape is that of an oval disk. 

The ligaments of the larynx are the crico-thyroid r the 
middle thyreo-hyoid, the lateral thyreo-hyoid,, and the thy- 
Teo-arytenoid two in number on each side of the larynx, one 
above the other, three lines apart. These ligaments also 
have the name of ligamentum vocale, and the portion of the 
larynx which is formed by them, and the pouches between 
them which are called the ventricles of Galen, is the struc- 
ture essential to the formation of voice. The opening be- 
tween the two lower ligaments is called the rima glottidis; 
and the space between the upper ligaments and the duplica- 
ture passing from the arytenoid to the epiglottis, is called 
glottis. 

The muscles of the larynx are the thyreo-hyoideus, crice- 
thyroideus, crico-arytenoideus posticus, and lateralis, thy- 
reo-arytenoideus, arytenoideus-obliquus, and transversus, 
thyreo-epiglottideus, and aryteno-epiglottideus. 

The nerves of the larynx come principally from the supe- 
rior and inferior laryngeal branches of the par vagum. 
Trachea. 

What are the characteristics of the trachea? It is a. cy- 
lindrical canal four or five inches long, and nine lines in di- 
ameter; it opens into the larynx above, and terminates in 
the thorax opposite to the third dorsal vertebra, by two bran- 
ches called bronchiae. The structures which enter into the 
composition of the trachea are cartilage, ligamentous fibre* 
muscle, and mucous membrane. 

The cartilage preserves the shape, and consists of from 
sixteen to twenty distinct rings, which are deficient at their 
posterior third. 

The ligamentous structure exists between the proximate 
margins of the rings, and fills up the intervals between them 
so as to render the tube perfect. The deficiency in the rings 



ANATOMY, 



posteriorly, is supplied in part by condensed cellular sub- 
stance. 

The muscular structure exists at the cartilaginous defi- 
ciency in the posterior third; the fibres pass in a transyerse 
direction between the interrupted extremities of the rings; 
it is between the condensed cellular substance and the mu- 
cous membrane of the trachea. 

The mucous membrane lines the whole internal portion, 
from the larynx to the bronchise, throughout all their rami- 
fications. 

Where is the thyroid gland situated ? It is placed on the 
first and second rings of the trachea, and on the sides of the 
larynx united in the centre by its isthmus. 

Where is the thymus gland situated } Between the tra- 
chea and upper extremity of the sternum. 
Lungs. 

What are the characteristics of the lungs? They are es- 
sentially the seat of the process of respiration, and occupy 
nearly the whole cavity of the thorax. They are two bodies 
of a greyish pink color, separated by the heart and its great 
vessels, and each forms an irregular cone with the apex above. 

The right lung is divided into three lobes, and the left in- 
to two. Each lobe is divided into distinct lobules, united 
by cellular tissue. The lobules are subdivided into fine air 
cells; these cells communicate laterally in the individual 
lobules, but not with the cells of different lobules. Each 
lobule has a ramification of the bronchial tube sent to it. 

The blood vessels are of two kinds; the pulmonary, and 
bronchial. The former is for the aeration of the blood, and 
the other for the nourishment of the lungs. 

The nerves come from the par vagum and sympathetic. 

What composes the root of the lungs ? The root of each 
lung is formed by the pulmonary artery, and two veins, the 
nerves, bronchiae, lymphatic vessels, and glands, covered by 
the pleura, where it extends from the lungs to the pericardium 
Pleura. 

What is the arrangement of the pleura? They are two 
in number, afford a perfect covering for each lung, and 
are reflected over the adjacent sides of the pericardium, and 
the interior periphery of the thorax. 

That portion of the pleura which covers the lung, is call- 
ed pleura pulmonalis^ and that which lines the thorax is tha 
pleura costalis. They receive blood from the bronchial and 
intercostal arteries, and nerves from the intercostals. 



ANATOMY, 



The pleurae divide the thorax vertically, into two parts ; 
this septum is called mediastinum, and contains the heart, 
with its coverings, and great vessels. The mediastinum is 
divided into three portions. The anterior passes from the 
front of the pericardium to the posterior face of the middle 
line of the sternum. The posterior passes from the posterior 
face of the pericardium to the dorsal vertebrae. The supe- 
rior is within the circuit of the first ribs* 

What is contained in the posterior mediastinum'? The 
thoracic aorta, the oesophagus, the vena azygos, the thoracic 
duct, and the parvagum nerve of both sides. 

What is contained in the superior mediastinum? A part 
of the remains of the thymus gland, descending vena cava, 
transverse vein, or vena innominata, the top of the arch of the 
aorta, arteria innominata, left carotid, left subclavian, tra- 
chea, eesophagus, phrenic nerve, and par vagum. 

Circulatxxg- System. 

What is the apparatus by which the circulation is effected? 
The heart, which in man consists of four cavities, the arte- 
ries,, veins, and capillaries. 

What is the course and description of the circulation? 
The blood, after getting to the right auricle, is emptied by 
its contraction into the right ventricle, from which it is 
forced through the branches of the pulmonary artery into 
the lungs. It is returned through the four pulmonary veins 
to the left auricle of the heart, which contracts and throws 
the blood into the left ventricle, from which it is propelled 
by its contraction, into the aerta; it is then distributed to the 
whole body by its small branches, from which it is collected 
by corresponding veins, into the ascending, and descending 
cava, that empty into the right auricle. It will, therefore, be 
seen that there are two circulations, the greater or systemic, 
the arteries of which contain red blood, and the veins dark 
or venous blood; and the lesser or pulmonic, the arteries of 
which contain dark blood, and the veins red or vivified blood. 

What is meant by the capillaries? They are the extreme 
vascular ramifications which form the connexion between 
the arteries and veins. 

Of how many coats are the arteries composed? Three: 
an external, a middle, and an internal coat. 

The external or cellular coat is condensed cellular sub- 
stance, formed into a cylinder, the fibres of whieh run in 
ever}' direction. 

The middle coat, called also muscular, proper, or tendi- 



ANATOMY. 



nous ; is of a light yellow tinge, the fibres of which are cir- 
cular, and possess elasticity. 

The internal coat is sometimes called nervous and arach- 
noid. 

Cellular substance, vessels, and nerves, also enter into the 
structure of arteries. The blood vessels which nourish the 
arteries are called vasa arteriarum. 

Of how manv coats are the veins composed "? Three : an 
external, a middle, and an internal coat, analagous to the 
corresponding coats of the arteries, but more delicate in 
their texture. 

What are the different parts of the blood called ? Serum, 
crassamentum, and red globules. 

Heart. 

Where is the heart situated? In the thorax between the 
sternum and spine, having the lungs on either side, and tho 
tendinous centre of tho diaphragm below. 

It is surrounded by its proper membrane, the pericardium ; 
its weight is about 'six ounces, greatest length about five 
tind a half inches, and its base about three and a half inches 
in diameter. It is divided into four cavities; two of which 
are called auricles, and two ventricles; the auricles form the 
base ot the heart, and the ventricles its body. The right 
auricle and ventricle form the right side of the heart, and 
the left auricle and ventricle forms the left side. 

What are the characteristics of the right auricle) It is 
an oblong cuboidal cavity, joined at its posterior superior 
angle by the descending vena cava, and at its posterior infe- 
rior angle by the ascending cava. In front it is dilated into 
a pouch called sinus, the upper extremity of which is elon 
gated into a process with indented edges, called auricle, or 
auricular portion. On the septum between the auricles is 
the fossa ovalis, which is surrounded by its annul us, or the 
isthmus of Yieussens; below the fossa ovalis is the Eustachi- 
an valve. At the orifice of the large coronary vein is tho val- 
vular Thebesii. The opening into the right ventricle is the 
ostium venosum. In this auricle are fasciculi of muscular 
fibres called musculi pectinati. 

What are the characteristics of the right ventricle? It is 
of the form of a triangular -pyramid, forms the greater part 
of the anterior surface of the heart, and is about three lines 
in thickness. Its internal surface is covered by muscular 
5* 



ANATOMY. 



fasciculi called eommnae carrieae ; from some of these, small 
tendinous chords are sent to the valves, called chordae ten- 
dineae. The valves between thi-s ventricle and auricle are 
called tricuspid. The opening for the pulmonary artery is 
above, and furnished with three valves called semi-lunar, or 
sigmoid, which have in the centre of their edges, a small 
cartilaginous body, called corpusculum aurantii. Between 
the outer face of each valve, and the artery is a pouch called 
the sinus of Valsalva. 

What are the characteristics of the left auricle ? Its figure 
is more regularly quadrangular than the right. Its tip or 
ear-like portion is situated at the left of the pulmonary ar- 
tery, and it is longer, narrower, more crooked, and more 
notched than the right. The opening between the left au- 
ricle and ventricle is also called ostium venosum. 

What are the characteristics of the left ventricle? The 
shape of its cavity resombles a longovoidal or conical body, 
with its parietes about eight lines in thickness. Its internal 
surface has the same arrangement as the right ventricle in 
having the fleshy columns called columnae carneae. The os- 
tium venosum on this side is furnished by valves called the 
mitral, the margins of which are also furnished with chordae 
tendineac. The orifice of the aorta is furnished with three se- 
milunar valves corresponding exactly with those at the ori- 
gin of the pulmonary artery, except that they are thicker and 
stronger. 

The sinuses of Valsalva also exist in the same manner. 

What are the blood vessels of the' heart? They are the 
right and left coronary arteries, and great and lessor corona- 
ry veins. 

Where are the nerves of the heart derived from ? Princi- 
pally from the cervical ganglions of the sympathetic ; they 
follow the coronary arteries in their distribution. 

Arteries. 

What is the great trunk of the arterial system called? 
Aorta. 

What are the branches of the aorta? The right and left 
coronary arteries which go to the substance of the heart, 

From the arch; the arteria innominata, the left primitive 
carotid, and the left subclavian arteries. 

From the thoracic portion, the bronchial, ono for each 
lung and sometimes two or more; the oesophegai, which are 



ANATOMY, 



five or six small twigs; the posterior arteries of the medias- 
tinum ; and the inferior intercostals on each side, which sup- 
ply the ten lower intercostal spaces. 

From the abdominal portion; the phrenics, two in num- 
ber, the cceliac, the superior mesenteric, the capsular, one or 
more on each side, the emulgents, and spermatics, one on 
each side, the inferior mesenteric, the lumbar, five on each 
side, and the middle sacral arteries. It then terminates in 
the primitive iliacs. 

How is the arteria innominata divided? Into right sub- 
clavian and right primitive carotid. 

How arc the carotids on each side divided? Into inter- 
nal and external carotids, opposite to the os hyoides. 

What are the arteries given off by tiro internal carotid? 
The opthalmic, the communicating artery of Willis, the 
choroid, the anterior and the middle cerebral. 

What are the branches given off by the external carotid 
artery ? The superior thyroid, the lingual, the facial (which 
gives off the submental, the inferior labial, the inferior 
coronary, and the superior coronary), the inferior pharyn- 
geal, the occipital, and the posterior auricular, when it di- 
vides into two large trunks, the internal maxillary, and the 
temporal. 

The temporal gives off the transverse facial, the middle 
temporal, and the anterior and posterior temporal. 

The internal maxillary sends off the following branches : 
the arteria-tympanica, the arteria mcningca parva, the me- 
nlngea magna or media, the maxillaris or inferior dental, 
the temporalis profunda, two in number, pterygoidese, buc- 
cal ; s, maxillaris superior, infra orbit alis, palatina superior, 
pharyngca superior, and the sphcno-palatina, which is the 
terminating trunk. 

What are the branches given off by the subclavian arte- 
ries on each side? The vertebral, the inferior thyroid, su- 
perior intercostal, internal mammary, and posterior cervical ; 
after passing the subclavian muscle, it is called axillary ar- 
tery to the lower margin of the arm pit; and from this place 
to the elbow joint; it is called brachial. 

What are the branches of the axillary artery? The supe- 
rior scapular, four external mammary, inferior scapular, 
and the anterior and posterior circumflex. 

What, are the branches of the brachial artery? The pro- 
found, the small profound, nutritious, and anastamotic ; it 



ANATOMY. 



therf bifurcates into the radial and ulnar in front of the bra^ 
chialis internus muscle. 

What are the branches of the radial artery? The recur- 
rens radialis, superficialis volae, dorsalis carpi, magna polli- 
cis, radialis indicis, and the pal maris profunda, which forms 
the arcus profundus. 

What are the branches of the ulnar artery? The recur- 
rens ulnaris, the interossea anterior and posterior, and dor- 
salis manus. It then forms the arcus sublimus (from which 
branches are sent that supply the fingers, called digital), 
and terminates by a branch which joins the arteria magna 
pollicis. 

What are the branches of the coeliac artery ? It divides 
into three trunks; the gastric, hepatic, and splenic. This 
division is sometimes called tripus Halleri. 

The gastric artery passes along the lesser curvatute of 
the stomach. 

The hepatic artery gives off the right gastric or gas« 
tro-epiploic, which is distributed to the right half of the 
great curvature of the stomach, the main branch goes to the 
transverse fissure of the liver, and divides into the right and 
left branches. 

The splenic artery gives off the pancreatic, the left gas- 
tric, which is distributed to the left half of the great curva- 
ture of the stomach, and the vasa brevia, which are given 
off just before this artery enters the spleen; they are five or 
six in number, and distributed upon the great extremity of 
the stomach, between the cardia, and left gastric artery. 

What are the branches of the superior mesenteric artery? 
There are three colic arteries, called ileo-colica, colica-dex- 
tra, and colica-media, besides the principal distribution to 
the small intestines. 

What are the branches of the inferior mesenteric artery? 

The superior, middle, and the inferior colic arteries; and 
the superior haemorhoidal. 

How are the primitive iliacs divided? Into two trunks, 
called internal and external. 

What are the branches of the internal iliac artery? The 
ilio-lumbar, lateral sacral, obturator, middle haemorhoidal, 
vesical, uterine, gluteal, and the ischiatic. The ischiatic 
gives off the internal pudic, which again gives off the lower 
haemorhoidal, perineal urethro-bulbar, ramus superficialis 
dorsi penis, and the cavernous artery of tne penis. 



ANATOMY 



53 



What are the branches of the external iliac? The epi- 
gastric, and circumflex of the ilium. 

What is the extent of the femoral artery and what are its 
branches) It extends from the crural arch to its perfora- 
tion of the abductusmagnus ; and gives oft the superficial ar- 
tery of the abdomen, external pudics, profunda femoris 
which divides into external and internal circumflex) ; the- 
rst, second, third, and fourth perforating, and the anasto- 
mosing arteries. 

What is the extent of the popliteal artery and its bran- 
ches? It is a continuation of the femoral after its passage 
through the tendinous insertion of the adductor mag- 
nus; extends to the opening in the interosseous ligament, 
and gives off the superior internal, superior external, mid- 
dle, inferior internal, and inferior external articular arteries, 
and the gastrocnemial ; it then divides into the anterior, 
and posterior tibial arteries. 

What are the branches of the anterior tibial artery? The 
recurrent tibial, internal and external malleolar, tarsal, me- 
tatarsal, dorsal artery of the great toe, and joins with the 
external plantar in the sole of the foot. 

What are the branches of the posterior tibial? The pero- 
neal, the internal and external plantar; this last unites with 
the anterior tibial artery, and forms the arcus plantaris, 
which gives off the digital, and the perforating arteries. 

Vexotjs System. 

What is the office of the veins? To collect the blood 
from the arteries in all parts of the body, and return it to 
the heart. 

What is their general arrangement? There are two ac- 
companying each artery wherever the part is intended for 
locomotion; besides which there is an abundant class of su- 
perficial, or subcutaneous veins which form a vascular net 
work over the whole body. Those accompanying the arte- 
ries are termed venae comites, and take the names of the ar- 
teries which they accompany. In some other cases two ar- 
teries empty into one vein. 

What is their structure ? Their coats are much thinner 
than the arteries, but similar to them in structure. The in- 
ternal coat is thrown into duplicatures or valves, which are 
more abundant in the superficial than in the deep seated 
veins. 



ANATOMY. 



What is the great trunk of the venous system called ) 
Vena cava ascendens, and descendens. 

What veins form the vena cava descendens) The two 
venae innominatae. 

What forms the vena innominata? It is formed on either 
side by the junction of the subclavian with the internal ju- 
gular. 

What venous trunks discharge into the vena innominata, 
or descending cava? Inferior thyroidal, vertebral, superior 
intercostal, internal mammary, vena azygos, and some others 
of smaller size. 

What veins form the vena azygos ? The ten inferior in- 
tereostals of the right side, and four or six of the left; it an- 
astimoses inferiorly with some of the veins of the abdomen. 

What forms the internal jugular vein? It extends from 
the base of the cranium, where it communicates with the 
lateral sinus on each side, to the internal margin of the first 
rib. Its commencement is enlarged into what is called its 
gulf, or sinus. 

What forms the external jugular, and where does it ter- 
minate? It is a continuation of the temporal, receives the 
facial and lingual; and sometimes superior thyroid, and oc- 
cipital. It usually terminates in the subclavian. 

Where is the subclavian situated ? It extends from the 
axillary to the vena innominata, and goes under the subcla- 
vian muscle, in front of the subclavian artery; and where it 
passes over the first rib, the scalenius anticus muscle is be- 
tween them, the vein being in front of it. 

What forms the axillary vein, and where is it situated? 
The union of the basilic with the brachial vein. It is in 
front of the axillary artery, included in the same sheath, and 
involved with the axillary plexus of nerves. At the under 
surface of the clavicle it takes the name of subclavian. 

How are the veins of the superior extremities arranged ? 
Into deep seated and superficial. The former take the names 
of the arteries which they accompany, and are two to each 
artery. The latter are divided into two principal trunks; 
the cephalic and basilic. 

What is the situation of the cephalic vein? It is the 
trunk coming from the thumb and fore-finger, recives severe 
al small branches on its course, and terminates in the axiU 
lary vein. 

What is the situation of the basilic vein? It begins by 



ANATOMY. 



55 



the trunk from tne ulnar side of the hand, receives branches 
in its course, and by its union with the brachial, forms the 
axillary vein. 

What is the situation of the median vein?- It is in the 
middle and front of the fore-arm; its trunk ascends, and be- 
low the bend of the arm divides into two; one branch go- 
ing to the cephalic vein, and called median cephalic, and 
the other going to the basilic vein, is called median basilic. 

Where is the vena cava ascendens situated, and what 
branches does it receive? In front of the spinal column to 
its right, and extends from the junction of the primitive ili- 
ac veins (which unite to form it opposite the fourth lumbar 
vertebra) to the right auricle of the heart where it empties. 
It receives the middle sacral, lumbar, spermatic, emulgent, 
capsular, hepatic, and phrenic veins. 

What forms the primitive iliac vein on each side? The 
junction of the external and internal iliacs, opposite the sa- 
cro-iliac symphysis. 

What forms the internal iliac or hypogastric vein? It 
arises by venous branches corresponding with the distribu- 
tion of the hypogastric artery, some of which are termed 
plexus; and are the hemorhoidal, vesical, sacral, pudendal, 
uterine, and vaginal plexuses; and the gluteal, obturator, 
and ileo-lumbar veins. 

What forms the external iliac vein? It is a continuation 
of the femoral, and receives the epigastric, and circumflex 
iliac veins, which correspond with arteries of the same name. 

What is the arrangement of the veins of the inferior ex- 
tremities? Into deep seated and superficial. The former 
follow the course of the arteries, take the same name, and 
are two for every artery as far up as the ham, and also for 
the muscular arteries of the thigh. 

What are the superficial veins? The saphena minor, and 
major. 

What is the situation of the saphena minor? It com- 
mences near the external side of the top of the foot and ex- 
ternal ankle; the trunk ascends along the back of the leg- 
superficially, and terminates in the popliteal vein. 

What is the situation of the saphena major? It com- 
mences at the internal part of the foot; its trunk passes up- 
wards in front of tho internal ankle, internal face of the leg 
on a line with the posterior margin of the tibia, and is continu- 
ed on a line with the posterior margin of the sartorius muscle ; 



§6 



ANATOMY. 



it then terminates in the femoral vein about twelve or 
eighteen lines below Poupart's ligament. 

From whence is the vena portarum derived ? The visce- 
ra of the abdomen, and corresponds with the superior and 
inferior mesenteric arteries, and the coeliac, with the excep- 
tion of the hepatic branch. 

What is meant by the sinus portarum? The vena porta- 
rum when it reaches the transverse fissure of the liver di- 
vides into a right and left branch, at right angles with the 
main trunk, but in a line with one another; these constituto 
the sinus portarum. 

Where do the terminating branches empty ? Into the ve- 
nae hepaticas. 

Absorbent ok. Lymphatic System. 

What are the absorbents? They are small, pellucid, 
transparent, cylindrical tubes, whose office is for interstitial 
absorption, and also to take up the nutritious part of our 
food. 

How are the absorbent vessels divided? Into lacteals, 
and lymphatics. The former are those which absorb the 
chyle, and the latter are found in other parts of the system; 
their structure is similar, and differ only in the fluid with 
which they are occupied. They are also divided into su- 
perficial and deep seated 

What are lymphatic glands? They are flattened, ovoid- 
al bodies, of a reddish ash color, indurated, and of variablo 
volume, through which, the lymphatic vessels have to] pass 
on their way to the thoracic duct. The vessels that enter 
them are called vasa inferentia. -and those that depart vasa 
efferentia. 

Where are they found? In clusters, below the occiput, 
under the ears and jaw, along the side of the neck, in the 
axilla, root of the lungs, mesentery, loins, pelvis, &c. 

What are the main trunks called? Thoracic ducts. 

What is the course and arrangement of the thoracic 
ducts? The left thoracic duct is the main trunk of the ab- 
sorbent system. It begins about the second or third lumbar 
vertebra. Shortly after its commencement it is dilated, and 
this dilatation is called the reservoir of Pecquet, or recepta- 
culum chyli. The thoracic duct enters the thorax between 
the crura of the diaphragm, ascends to the fourth dorsal 
vertebra, when it inclines to the left side, ascends into the 



ANATOMY. 



57 



neck near the head of the first rib; it then turns downwards 
and forwards, over the left subclavian artery, and dischar- 
ges into the point of junction of the left subclavian, and in- 
Ternal jugular veins. It is commonly about the size of a 
crow quiil. 

The right thoracic duct, or as it is sometimes called, the 
right brachiocephalic, is about one inch long, and descends 
to empty itself into the junction of the right internal jugu- 
iar with the right subclavian veins. It is formed by the lym- 
phatic trunks of the right side of the head and neck, from 
the right upper extremity, and the superficial lymphatics of 
the right side of the thorax, and parts adjacent to it. 

Nervous System. 

How is the nervous system divided? Into the central or 
internal part, composed of the brain and spinal marrow; 
and the external, or peripheral portion, which consists in the 
nerves of the brain and spinal marrow. 

Tho central portion is composed of two kinds of sub- 
stance; one called medullary, and the other cineritious. 

Tho peripheral portion, or the nerves, are formed by par- 
allel fasciculi, the finest filaments of which, are composed 
of a tube filled with nervous matter. Tho sheaths of the 
nerves is called neurilemma; it envelops the nerves, and also 
forms an envelope for each particular fibre, and fasciculi. 

There are three modes by which these fasciculi unite 
with each other, by anastomosis, plexus, and ganglion. 

Spinal Marrow. 

What arc the characteristics of the spinal marrow 1 ? It is 
within the vertebral cavity, and extends from the first ver- 
tebra of the neck to the first or second of the loins, inclu- 
sive. It has three membranes; dura mater, pia mater, and 
Lunica arachnoidea ; its general form is cylindrical, flattened 
slightly before and behind; its substance is of two kinds; 
cineritious, and medullary. 

The spinal marrow gives off from its sides thirty pairs of 
nerves; eight of them are called cervical, twelve dorsal, five 
lumbar, and five sacral. The spinal nerves are formed from 
two roots; an anterior, and a posterior, which are separated 
by the ligamenturn denticulatum. 

The arteries of the spinal marrow are derived from th^ 
vertobrals, intercostals, lumbar, and sacral. 
6 



58 



ANATOMY. 



Brain, 

What is understood by the encephalon, or brain? It is 
that part of tho central portion of the nervous system con- 
tained within the bones of the cranium ; of an oval shape, 
surrounded by three membranes, the dura mater, tunica ar- 
achnoidea, and pia mater. Its substance is divided into ci- 
neritious and medullary. 

The brain is divided into medulla oblongata, protuberan= 
tia annulare, or pons Varolii!: cerebrum, and cerebellum, 
each of which are symmetrical, and consist in right and left 
halves, perfectly alike. 

What are the processes of the dura mater? Falx cerebri, 
tentorium cerebelli, and falx cerebelli. 

What are the sinuses of the dura mater? Superior Ion- 
gitudinal, lateral, one on each side, inferior longitudinal, 
sinus quartus or' rectus, petrous two on each side, the su- 
perior and inferior, cavernous one on each side, circular, 
and the occipital. 

What is the torcular Hierophili? It is the union between 
the longitudinal, the fourth, and the lateral sinuses. 

What are the characteristics of the medulla oblongata? 
It extends from the superior margin of the first cervical ver- 
tebra to the middle of the basilar process of the os occipitis. 
On its under surface, on each side, is the corpus pyramidalo. 

The eminentia clivaria are two bodies, one on either side, 
at the external margin of the pyramidal bodies. 

The corpora restiforme, one on either side, are placed at 
the lateral margins of the medulla oblongata, posterior to 
the olivaria, and is a continuation of the posterior portion of 
the medulla spinalis. Between the corpora restiforme on 
the superior face of the medulla oblongata is an excava= 
tion, named from its shape calamus scriptorius, which forms 
a part of the floor of the fourth ventricle of tho brain. 

What are the characteristics of the pons varolii? It is a 
large projecting body, placed at the top of the medulla 
oblongata upon the junction of the body of tho sphenoid 
bone with the basilar process of the os occipitis, convex, 
and about one inch in diameter. 

What are the characteristics of the cerebellum? It is in 
the posterior fossa of the cranium, separated from the pos- 
terior lobes of the cerebrum by the tentorium, and connected 
with the pons varolii, by the erus of the cerebellum. It 



ANATOMY. 



measures four and a half inches in the transverse diameter, 
two and a half in thickness, and about the eame from 
before backwards. It has on its superior face the sulcus 
superior cerebelli; another on the inferior surface, called the 
sulcus inferior cerebelli. 

The superior middle ridge is called vermis superior, the 
anterior extremity of which is from its elevation called 
monticulus cerebelli. The vermis inferior is a ridge occu- 
pying the deep sulcus which divides the cerebellum on its 
inferior surface into hemispheres. The central part of tho 
cerebellum is formed by the vermis superior, and inferior, 
and is the fundamental portion. 

The valve of Vieusscns arises from the cerebellum under 
the anterior part of the base of the monticulus. 

The corpus rhomboideum, or dentatum, is in the middle 
of the trunk of the arbor vitae. 

What are the characteristics of the cerebrum? It weighs 
about three pounds, it is ovoidal, measures about six inches 
in its antero posterior diameter, five inches in breadth, and 
four or five deep. It is separated by the longitudinal fissure 
into hemispheres, the right and left. At the bottom of this 
fissure is the corpus collosum, which connects the two hem- 
ispheres together. The hemispheres are each divided on 
their under surface into three lobes, anterior, middle, and 
posterior. The anterior is anterior to the fissure of Sylvius; 
the posterior rests on the tentorium, and the middle is be- 
tween these two. The periphery is formed into convolu- 
tions, called gyri, and these are separated by fissures called 
sulci. 

The crura cerebri are about eight lines long, mutually 
diverge, and are separated by a fissure, which is the third 
ventricle of the brain. 

The eminentia mammilares, or corpora albicantia, are two 
small bodies, one on oach side, situated near the anterior 
extremities of the crura cerebri. 

The infundibulum is placed immediately before the emi- 
nentia mammilares. It is flattened, conoidal, half an inch 
long, base upward, and its apex going downwards and for- 
wards. Its base is hollow, and opens into the third ven- 
tricle, but the point is closed. 

The pituitary glainTjis situated in the sella turcica. 

The tuber cinerum, or pons tarini, is a portion of the 
under surface of the crura cerebri. 



60 



ANATOMY, 



The tlialami optici, two in number, called also ganglia 
postica, are situated on the superior face of the crus cerebri, 
about an inch and a half in length, and eight lines broad 
and deep. The thalami are medullary externally, cortical, 
and medullary internally, and united to each other by the 
commissura mollis. 

The corpora striata, or ganglia cerebri antica, are two 
pyriform bodies, situated before the thalami, at the bottom 
of the lateral ventricles. They are two and a half inches 
long, convex in their upper surface, eight lines broad at the 
front, and taper backward to a point. The septum lucidum 
is between them in front, but posteriorly they diverge so as 
to admit the thalami between them. The taenia striata is 
placed in the angle formed between the internal margin 
of the corpus striatum, and the external one of the thala- 
mus opticus. It is a small medullary band commencing 
near the anterior crura of the fornix, and observing the 
course of the curved fissure in which it is placed; it goes 
to the posterior end of the corpus striatum. 

The corpus callosum is placed at the bottom of the 
fissure which separates the two hemispheres, and may be 
brought into view by slicing them off' to a level with it. It 
is then seen to be a medullary layer uniting the mass of tho 
two hemispheres, for two-fifths of the long diameter of the 
brain, about eight lines in breadth, marked by a middle line 
called raphe, and forms the roof of the lateral ventricles. 

The fornix or trigone cerebral is placed immediately 
below the corpus callosum. It is' triangular, the base of 
which is behind, and the apex in front, about an inch and a 
half long in its body, and one inch wide at the base, which 
is beneath tho corpus callosum, continuous with it, and gives 
tho fornix the appearance of being a part of the same struc- 
ture doubled on itself. 

The septum lucidum is a partition placed vertically in the 
middle of the brain, and extends from the corpus callosum 
above, to the fornix below; between its lamina is situated 
tho fifth ventricle, or ventriculus septi. 

The pineal gland is beneath the posterior margin of the 
fornix upon the superior part of the tubercular quadrigem- 
ini. 

Tho velum intcrpositum is a reflection of pia mater, sepa- 
rating tho pineal gland from the fornix, and the fornix from 
tho thalami nervorum opticorurrr, 



ANATOMY, 



6i 



The tubereula quadrigemini are situated on the supe- 
rior face of the crura cerebri, and just behind the thalami. 

How many ventricles of the brain are there? Four; two 
lateral, placed one in either hemisphere of the cerebrum, 
the third, between the two thalami, and the fourth under 
the cerebellum. 

The lateral ventricles each consist of a body and three 
processes, called cornua. The cornua are named from their 
position anterior, posterior, and lateral, or inferior. 

In the posterior cornu are seen the hippocampus minor. 
In the inferior, or lateral cornu is found the cornu ammonis, 
or hippocampus major, terminated by the pes hippocampi. 

The third ventricle is bounded below by the pons tarini, 
crura cerebri, and the eminentiae mammillares; and above 
by the velum interpositum, and fornix. 

The fourth ventricle is bounded in front by the tuber an- 
nulare, and medulla oblongata; behind by the fundamental 
portion of the cerebellum ; above by the valve of the brain 
and tuborculi quadrigemini ; laterally by the medullary 
prolongations, from the cerebellum to the tubereula quadri- 
gemini, and is open below when the pia mater is removed* 
Nerves. 

The following nerves are in pairs and the description of 
one side applies equally to the other : 

Where does the olfactory nerve arise from? By three 
fasciculi or roots from the basis of the brain, at the corpus 
striatum, in the fissure of Sylvius. They unite, and at the 
anterior extremity this nerve is enlarged into what is term- 
ed the bulb, which sends from its under surface filaments to 
the Schneiderian membrane through the cribriform plate of 
the ethmoid bone. 

Where does the optic nerve arise from? It arises by a 
broad flattened root, a portion from the thalamus opticus, 
and another part from the testis, it also adheres to the crus 
cerebri, and passes under it. The optic nerves of the two 
sides are fused together, and form what is called their chi- 
asm, or crossing; after this they separate, and each one pas- 
ses through the optic foramen of its respective side. 

Where does the third pair of nerves arise from? From 
the internal face of the crus cerebri, two lines in advance of 
the anterior margin of the tuber annulare. It penetrates the 
orbit, through the sphenoidal fissure, and it is distributed to 
most of the muscles of the eye ball. 
6* 



ANATOMY. 



• Where does tlie fourth pair of nerves "arise from? Tt 
arises by two filaments from the upper anterior face of tho 
valve of the brain. It goes to the orbit through the sphenoi- 
dal fissure, and is distributed to the superior oblique muscle. 

Where does the fifth pair of nerves arise from? By seve- 
ral distinct filaments from the pons Varolii, or tuber annu- 
lare. They unite, and form tho semilunar ganglion, or gan- 
glion of Gasser, which sends off three branches, viz: the 
first, or ophthalmic, through the sphenoidal fissure; the se- 
cond, or superior maxillary through the foramen rotundum ; 
and the third, or inferior maxillary, through the foramen 
ovale. Their general distribution is to the orbit, the face, 
and the tongue. 

Where does the sixth pair of nerves arise from? From 
the base, or upper extremity of the corpus pyramidale. It 
passes into the orbit by the sphenoidal fissure, and is distri- 
buted upon the abductor occuli muscle. 

Where does the seventh pair of nerves arise from 1 That 
portion of the seventh pair, called the facial, or portia du: 
ra, arises by two branches from the medulla oblongata. It 
emerges through the stylo-mastoid foramen, and is distribu- 
ted to the muscles, and skin of the head. 

That portion called the auditory, or portia mollis, arises 
from the medullary striae on the surface of the calamus 
scriptorius, and from the corpus restiforme. It penetrates tho 
meatus auditorius interims, and is distributed to the laby- 
rinth of the ear. 

Where docs the eighth pair arise from? That portion of 
the eighth pair, called glossopharyngeal, arises from the 
posterior cord of the medulla oblongata. It emerges through 
the foramen lacerum posterius, and is distributed to the 
tongue, and pharynx. 

That portion called pneumogastric, arises from the cor- 
pus restiforme of the medulla oblongata. It passes out 
through the foramen lacerum posterius, and is distributed 
to the organs of respiration, and to the stomach. 

That portion called the accessory nerve, arises from the 
posterior fasciculus of the medulla oblongata, and spinal 
marrow. It is formed by the union of six or seven roots 
from the spinal marrow, and three or four from the medulla 
oblongata, and passes into the cavity of the cranium through 
the foramen magnum, passes out again through the foramen 
lacerum posterius, and is distributed to the muscles, and m, 
teguments of the neck, 



ANATOMY, 



Where does the ninth pair of nerves arise from? By se- 
veral fasciculi, from the fissure which separates the corpus 
pyrimidale from the corpus olivare, on the medulla oblon- 
gata. It gets out of the cranium through the anterior con- 
dyloid' foramen, and is distributed to tho muscles of the 
tongue. 

From whence are the arteries of tho brain derived? From 
the internal carotids, and vertebrals. 

The internal carotid passes into the cranium through the 
carotid canal ; when it reaches the anterior clinoid process, 
it sends oft' the ophthalmic artery to the orbit. It is then 
distributed to the brain by the arteria choroidca, arteria eal- 
losa, or anterior cerebri, arteria comrnunicans anterior, and 
the arteria cerebri media. 

The vertebral artery is a branch of tho subclavian, and 
passes through the transverse processes of tho six superior 
vertebras of the neck, enters the cranium through the occipi- 
tal foramen, and continues till it reaches the posterior mar- 
gin of the tuber annulare, when the two coalesce, and form 
a single trunk called the basilar. Before this union, it sends 
off tho spinalis posterior and anterior, and the inferior cere- 
bcUi. Tho basilar gives off the arteria superior cerebeili; 
it then divides into the posterior artery of the cerebrum, One 
on each side. These last arteries are joined by the arteria 
comrnunicans posterior, which completes the circle of 
Willis. 

How is the circle of Willis formed? Anteriorly, and lat- 
erally by the internal carotids, and their branches: the pos- 
terior part by the basilar, and its bifurcation; and forms a 
freo communication between the vessels of tho two sides of 
the brain, 

Sexses. 

From what source is the pituitary membrane supplied 
with nerves? From the olfactory, or first pair, and from the 
fifth pair. 

From what source is the blood vessels of the nose de- 
rived? From the internal maxillary, and the ophthalmic 
arteries. 

Eye. 

What constitutes the organ of vision? The ball of the 
eve, and its auxiliary parts. 

What are the auxiliary parts of the eye? The eye lids, 
or palpcbrae, supereilia, ligamentum palpebrals externum. 



64 ANATOMY 

conjunctiva, glands of .Meibomius, cilia, 'muscles, lachry- 
mal aparatus, consisting of the lachrymal glands, lachrymal 
duct, lachrymal sac, lachrymal caruncle, semilunar valve, 
or fold, and puncta lachrymalia. 

The muscles are the levator palpebrae superiorus, the four 
recti, and two oblique. 

What nerves supply the orbit of the eye? They are 
derived from the motor oculi, or third pair, the trochlearis, 
or fourth pair, the first branch of the trigeminus, or fifth pair, 
and the motor oculi externus, or sixth pair. 

What arteries supply the orbit of the eye? The ophthal- 
mic, which has numerous branches. 

What forms the ball of the eye? It is formed by con- 
centric tunics, and humours contained in them. The tunics 
are the sclerotica, and cornea externally; the choroidea, and 
the iris next in order; and the retina internally. 

The humours are the vitreous, which constitutes the 
principal part of the eye ball ; the crystalline which is in 
front of the vitreous, and the aqueous, between the crys- 
talline, and the cornea. 

The choroid coat is united at its anterior margin to the 
sclerotica by the ciliary ligament. 

The pigmentum nigrum is spread over the whole internal 
surface of the choroid, between hand the retina. 

The vitreous humour is composed of the tunica hyaloidea, 
and a thin fluid. 

Ear. 

How is the ear divided? Into the external ear, the 
tympanum, and the labyrinth. 

Of what is the external ear composed? It is formed of 
the exterior portion commonly called the ear, and by a 
canal which leads internally to the tympanum. The outer 
portion is divided into pinna, and lobus, the former is the 
cartilaginous portion, and the latter is soft, and pendulous 
attached to its inferior portion. 

The different parts of the external ear are, the concha, 
meatus auditorius externus, the helix, antihelix, fossa 
innominata, tragus, and antitragus. 

The muscles of the external ear are very feebly de- 
veloped, and are helicis major, and minor, tragicus, anti. 
tragicus, transversus auriculae, attolens auriculae, retrahens 
auriculae, and the anterior auriculae. 

What is the situation of the tympanum? It is interposed 



ANATOMY. 



65 



between the meatus auditprius, and the labyrinth. It is 
three lines in depth, six in the antero posterior diameter, 
and the vertical measurement about the same. 

The membrana tympani is situated between the meatus 
externus, and tympanum, and is composed of four lamina. 

The floor of the tympanum is marked by a rising, called 
the promontory, and openings called the foramen ovale, and 
foramen rotundum; the latter in the dried bone is the open- 
ing to the cochlea. 

The eminentia pyramidalis is a small eminence, project- 
ing from the posterior part of the tympanum; it is hollow, 
and communicates at the other end w T ith the canal of Fal- 
iopius. 

The eustachian tube is at the fore part of the tympanum, 
and communicates at the other extremity with the pharynx, 

The bones in the tympanum are tlie malleus, incus, 
orbiculare, and stapes, which are successively articulated, 
so as to form a chain. The muscles which move these 
bones are the laxator tympani, tensor tympani, stapedius, 
and the laxator tympani minor. 

What is the situation of the labyrinth? It is placed on 
the inner side of ihe tympanum, and is divided into three 
portions, the vestibulum, semicircular canals, and the 
cochlea. 

The nerves which are spent in part or wholly upon the 
organ of hearing, are the auditory, portio dura, and tri- 
geminus, or fifth pair. 

The Great Sympathetic Nerve. 

What is meant by the sympathetic nerve? It consists in 
a series of ganglions, extending from the base of the cra- 
nium to the lower extremity of the sacrum. These ganglions 
are united together by an intermediate nervous cord; and 
send off filaments to adjacent organs; there is one of them 
for each intervertebral space, except those of the neck. 
Besides those there aro several others, situated around the 
trunks of some of the large vessels. 

What nerves form the commencement of the sympa- 
thetic ? It is formed by a branch of the nervus motor 
externus oculi, and one from the vidian nerve. These send 
each a twig downwards, through the carotid canal when 
they unite into a single chord that runs into the superior 
part of tjie superior cervical ganglion, 



6G 



ANATOMY. 



How many cervical ganglions are there? Three, a supe- 
rior, middle, and inferior. 

The first is opposite to the transverse process of the 
second cervical vertebra, and behind the internal carotid 
artery. The middle is opposite to the space between the 
fifth and sixth cervical vertebra. The inferior is formed in 
the interval between the head of the first rib, and the 
transverse process of the last cervical vertebra. 

Where is the cardiac plexus situated? Between the arch 
of the aorta and the lower part of the trachea, and bron- 
chiae. It is formed principally from the branches sent by 
the three cervical ganglions of the sympathetic of each 
side; there are filaments also from the recurrent and the 
par vagum. This plexus is distinguished by the softness of 
its texture, and its branches may be divided into anterior, 
posterior, and inferior. 

How many thoracie ganglions of the sympathetic are 
there? Twelve; they are placed on or near the heads of 
the ribs, are connected together by the main chord of the 
sympathetic, and receive filaments from the dorsal nerves'. 

What are the branches of the thoracie ganglions? The 
great splanchnic nerve arises by small branches from the 
sixth, to the ninth, or tenth thoracie ganglions, inclusive. 

The small splanchnic nerve is derived from the tenth 
and eleventh thoracie ganglions. 

Where is the semilunar ganglion situated? On each side 
of the aorta, and is formed by an assemblage of several 
smaller ones, which receive their fasciculi from the great 
splanchnic nerves. These several ganglia are united to- 
gether, and form the root of the solar plexus, from which 
proceed branches to the viscera : viz. the cceliac, or stomachic 
plexus, to the liver duodenum and pancreas, the splenic to 
the spleen, &c, each following the arteries as they proceed 
to their respective destinations. 

How many lumbar ganglions of the sympathetic are there ? 
Five on either side, placed anteriorly on the sides of the 
bodies of the lumbar vertebrae. 

How many are there of the sacral ganglions? General- 
ly three, sometimes four, or five, on the anterior face of the 
sacrum, near the corresponding foramina for the transmis- 
sion of the sacral nerves. The last of the sacral _ ganglions 
detaches downwards one or more filaments, which anasti- 
mose with the corresponding ones of the opposite side, and 



ANATOMY. 



forma a sort of arch, which is the termination of the sympa- 
thetic nerve. 

Spinal Nerves. 

How are the nerves of the medulla spinalis arranged ? 
Into cervical, thoracic, and abdominal. 

What is the origin of the phrenic nerve? It arises from 
the anterior fasciculus of the second and third cervical, and 
generally by two or three filaments from the upper part of 
the brachial plexus. 

What nerves contribute to form the brachial plexus? 
The anterior branches of the four inferior cervical nerves, 
and the first dorsal or thoracic. It extends from the scale- 
nii muscles to the axilla on a level with the neck of the os 
humeri, and surrounds the axillary artery, like the braids of 
a whip chord, from the clavicle to the os humeri, below its 
head. 

What nerves proceed from the axillary or brachial plex = 
us? The scapular, thoracic, axillary, two cutaneous, ra- 
dial, ulnar, and median. 

What is the number of thoracic, or dorsal spinal nerves ? 
They consist of twelve pairs. 

What is the number of the abdominal spinal nerves? 
There aro five lumbar, and five, sometimes six sacral, on 
each side. 

The anterior fasciculi form a plexus from the upper part 
of the loins to the lower part of the sacrum, called the plex- 
us cruralis, which has been divided by anatomists into plex- 
us lumbalis, formed by the four superior lumbar nerves, and 
the plexus ischiadicus, formed by the last lumbar, and the 
sacral. 

What are the nerves given off by the lumbar plexus? 
The cruralis anterior, nervus obturatorius, a branch running 
to join the sciatic plexus, tho abdomino crural branches, 
spermaticus externus, cutaneous externus, cutaneous medi- 
us, cutaneous anterior, and cutaneous internus. 

What are the branches which are given oft' by the sciatic 
plexus or plexus ischiadicus? The nervi glutei, nervus pu- 
dendals longus inferior, ramus femoralis cutaneous posteri- 
or, nervus pudendalis longus superior, and the nervus ischi- 
adicus, or great sciatic. 

What is the division of the great sciatic nerve? The 
popliteal or posterior tibial, and the peroneal; and in its 



68 



ANATOMY. 



course gives off the eutaneus interims superior, the cutane- 
ous internus inferior, and a large trunk or three distinct 
branches, which go to the adductor magnus, semi-membra^ 
nosus, biceps, and semi-tendinosus. 

The peroneal nerve divides into two branches, the pero= 
neus externus, and the tibialis anterior. 

The posterior tibial, or popliteal nerve, gives off the exter- 
nal saphenus, and several small branches to the muscles of 
the leg, when it divides in the hollow of the 03 calcis into 
the internal and external plantar nerves. 



P A R T 1 1 .— C H E M I S T R Y . 



What is Chemistry] It is the science which makes 
known the composition of bodies, and the manner which 
they comport with each other. — Bcrzelius. 

Caloric. 

What is understood by the term caloric? It is the cause 
or agent producing the sensation and phenomena of heat. 

What are some of the properties of caloric, or heat? It 
has been supposed to be a subtle fluid, the particles of 
which repel each other, and are attracted by all other sub- 
stances ; it is imponderable ; present in all bodies ; transferable 
from one body to another, tending to an equilibrium in two 
ways, by direct contact, or conduction, and by radiation. 

How are bodies divided in regard to their power of con- 
ducting caloric? Into conductors, and non-conductors; 
among the former are the metals, and among the latter, or 
those which conduct very imperfectly, are glass, wood, 
charcoal, and porous substances generally. The best con- 
ductors of the metals are, first, silver; then gold, copper, and 
tin ; then platinum, iron, and lead. 

Are liquids good conductors? Liquids are good conduc- 
tors only from the mobility of their particles, by which they 
change their places, and thus carry heat though them 
rapidly, if it is applied at the bottom. But if it is applied 
at the top the conducting power is very feeble. 

What is understood by the radiation of caloric ? When 
heat passes from one body to another, independent of a 
medium, therefore in vacuo, it is termed radiation; and the 
heat so distributed is called radiant or radiated heat. 

Suppose a heated body suspended in the air is reduced to 



70 



CHEMISTRY, 



an equilibrium, what are the modes by which it is accom- 
plished? It is done in three ways; first, by the conducting 
power of the air, which is very trifling; secondly, by the 
mobility of the air in contact with it; and thirdly, by ra- 
diation. 

How is heat distributed in radiation ? It is emitted from 
the surface of a hot body equally in all directions, in right 
lines, like radii from the center to the circumference of a 
sphere; and when they fall upon another body are dis- 
tributed in three ways; reflected, absorbed, or transmitted. 
In the first and third cases the temperature of the body on 
which the rays fall are not affected, in the other it is in- 
creased. 

In what proportion does heat decrease as we recede from 
a body? It diminishes in the ratio of the squares of the 
distances from the radiating body. 

Is the radiating power of a body influenced by the nature 
of the radiating surface? It is; a polished plate of metal, 
radiates very imperfectly, if roughened its radiating power 
is increased; and if covered with a thin layer of paper, 
isinglass, wax, or resin, it is greatly increased. 

The color of surfaces also has a greet effect on the radi- 
ating power; black radiating the most rapidly, red less, and 
white still less. 

Can heat be reflected when unaccompanied with light? 
It can, and is subject to the same laws in this respect that 
light is. 

Will a good radiating surface make a good reflector? No : 
neither will a good reflector make a good radiator, these 
properties being inversely to each other. 

When heat strikes an opaque body, and it is not reflected, 
what becomes of it? It is invariably absorbed; and these 
rays are supplimental to the rays which may be reflected if 
any are reflected. 

What relation exists between the absorptive, and the re- 
flective powers of bodies? They arc in an inverse propor- 
tion to each other. So that the more rays of heat that are 
absorbed by a body the fower are reflected, and vice versa. 

What relation exists between the radiant, and absorptive 
power of bodies? Those surfaces of bodies which have 
the absorptive power, have, the radiating power directly 
proportional. 

So that one class of surfaces are good absorbers, and ra- 



CHEMISTRY. 



n 



diators, while another are good reflectors, and retainers; 
these qualities being in various proportions in different 
surfaces. 

What is meant by transmission of heat? It is its passage 
unchanged, or nearly so, through transparent media, or 
through a vacuum. 

By what means do bodies attain and keep up an equality 
of temperature?- According to the theory of Prevost all 
bodies are constantly radiating heat, or calorific rays, and 
that the temperature of a body falls when it radiates mora 
than it absorbs; on the contrary, the cooler body becomes 
warmer when it -absorbs more than it radiates; and the 
temperature is stationary w r hen the quantities emitted and 
received are equal. 

An instance of tho first case is exhibited when a hot 
body is surrounded by colder ones; of the second, when a 
colder one is surrounded by warmer, and of the latter, when 
the temperature of tho bodies near each other is equal. 

According to another theory, bodies of equal temperature 
do not radiate at all, and when the temperature is unequal 
the hotter bodies alone radiate. 

What aro some of the effects of heat on matter? It is 
essential to vital actions, both animal, and vegetable. It 
influences the form of bodies, as regards their condition 
of solidity, fluidity, or vapour. It afso powerfully influ- 
ences chemical action and combination. 

Does heat invariably pypand all bodic3? It does w 7 ith 
the exception of some fluids, which are expanded also at 
high temperatures, and are contracted as tho temperature 
falls, until at a certain temperature they again expand, 
forming an exception to the general law. 

Upon what principle is a thermometer founded? The 
expansibility of fluids, and mercury is the one generally 
used. 

. Upon what principle is the pyrometer of Wedgewood 
formed ? If we heat a mixture of aluminous earth and 
water or clay, it contracts from the expulsion of the water, 
and this contraction is an indication of the amount of heat 
to which it has been subjected. 

What is understood by specific heat? It is tho quantity 
of heat which one body contains compared with other 
bodies. This difference in bodies is sometimes termed ca- 
pacity for heat. 



n 



CHEMISTRY. 



Wliat is understood by sensible, and insensible heat? 
Sensible heat is that heat of which we can take cognizance 
by our senses; and insensible heat is that which is proven 
to exist in a body, but does not affect our sensations, or our 
means of measuring temperature. 

Has every substance a specific heat peculiar to itself? It 
has; and a change of composition will produce a change of 
capacity for heat. 

When has a substance the greatest capacity for heat, in a 
solid, or liquid state? In a liquid condition. 

Does the specific heat of a gas vary with the density and 
elasticity? It does. A diminution of density increases the 
capacity, and vice versa. 

Is the specific heat of solids and liquids the same at all 
temperatures, when there is no change of composition? 

the temperature increases, the capacity increases, but it 
is owing to their dilatation, as in the case of gases. 

Does a change in specific heat produce a change in tem- 
perature? Always; an increase of capacity, therefore, of 
the specific heat, dimishes the temperature; and a decrease 
of capacity, is attended with an increase of temperature. 

What determines the condition of bodies as to their con- 
dition of solidity, liquidity, or gaseous state? The relative 
intensity of cohesion and repulsion. 

To what is the property of repulsion owing? To heat; 
and the form of bodies may be made to vary as this is in- 
creased or diminished. Every solid may be converted into a 
fluid, and every fluid into a vapor, provided our means for 
the production of heat are sufficiently powerful. 

Is heat absorbed and rendered insensible when bodies as- 
sume the liquid form ? It is ; and of course there is an in- 
crease of specific heat. This increase of specific heat is 
sometimes called the heat of fluidity, and seems necessary 
to the change. 

Is heat evolved, or made sensible during the passage of a 
liquid into a solid? It is; and a familiar instance exists in 
the formation of ice, which never gets below 32° w T hilo 
changing from a liquid to a solid state, let the surrounding 
temperature be what it may. 

How are aeriform substances divided? Into vapors and 
gases, and the differences between these, is the relative for- 
ces with which they resist condensation. 

What is meant by a fixed body? It ig a body which re- 



CHEMISTRY, 



73 



sists the strongest heat we are capable of producing with- 
out vaporizing. 

What is meant by a volatile body] It is a body which 
is converted into vapor by our means of producing heat. 

What is ebullition? It is where vapor is formed 
rapidly, giving rise to a commotion in the liquid; and 
the temperature at which this takes place is called the boil- 
ing point. 

What is meant by evaporation? It is where vapor is 
formed quietly and insensibly, and occurs at common tem- 
peratures. 

Is the boiling point of all liquids the same at the common 
pressure of the atmosphere ? No; sulphuric ether boils at 
96o F., alcohol at 176°, and pure water at 212 Q ,oil of turpen- 
tine 3l6°,and mercury 662°. 

What circumstances modify the boiling point of liquids? 
Variations in the pressure of the atmosphere is the principal 
one. The material of which the vessel containing the li- 
quid is composed, has an influence; also the presence of for- 
eign particles. Liquids boil in vacuo at 140° lower than in 
the open air, and if subjected to sufficient pressure, may be 
heated to any extent without boiling. 

What circumstances influence the process of evaporation? 
Extent of surface, and the state of the air. 

What are the sources of heat? The sun, combustion, 
electricity, the bodies of animals during life, chemical, and 
mechanical action. 

Light. 

What is meant by the science of optics? It is that sci- 
ence which treats of light and vision. 

What is the nature of light? According to Newton, it is 
an emanation of inconceivably minute particles from lumi- 
nous bodies; very subtle, and travels in straight lines with 
immense velocity. According to the other theory it is simp- 
ly vibrations, or" undulations, of a subtle ethereal medium, 
and gives rise to vision in a manner similar to what the un- 
dulations of the air impresses the nerves of hearing. 

What is meant by a ray of light? If is the smallest por- 
tion which can be -separated from contiguous portions. 

In what proportion does light decrease as we proceed from 
a luminous object? As the square of the distance from the 
luminous object increases, 
7 * 



74 



CHEMISTRY. 



When light falls on a body in what manner is it disposed 
of? It is either reflected, refracted, or absorbed. 

Is solar light simple, or compound) It is a compound of 
seven simple, or primary colors, viz : red, orange, yellow, 
green, blue, indigo, and violet. There are also rays of the 
spectrum termed calorific, and chemical, and to which some 
have added the magnetizing. 

What is understood by terrestrial light? It is artificial 
light; and the common method of obtaining it is by com- 
bustion. 

Electricity. 

What is understood by electricity? It is a principle call-, 
ed into action by rubbing substances called electrics, such 
as amber, glass, &c, with dry silk or cloth, and which 
causes contiguous light bodies to move towards them or be 
attracted, and the substance possessing this property of at- 
traction is said to be electrified. 

What is this attraction called? Electric attraction. 

What takes place when these light substances come in 
contact with an electrified body? They recede or are re- 
pelled, and this property is called electric repulsion. 

Gan this property or electricity be conducted from one 
body to another? It can by some substances, but not by 
others, hence bodies are divided into conductors, and non- 
conductors. 

What are the conductors? Metals, charcoal, plumbago, 
water, and substances which contain water in its liquid 
state. 

Are electrics conductors? No; they may be handled 
without loosing their electricity except at the parts touched; 
on the other hand conductors are non-electrics, because the 
electricity is at once carried off. 

Can a conductor be electrified or excited? It can by be- 
ing insulated or cut off from contact with the earth, either 
directly or indirectly by means of a non-conductor. 

Why do electric experiments usually fail in damp weath- 
er?- Because the atmosphere then acts as a conductor, and 
conducts the electricity off. 

What are the different conditions of electricity? There 
is one called vitreous because developed on glass, and ano- 
ther called resinous because developed on resinous substan- 
ces. They are also termed positive, and negative, the terms 



CHEMISTRY. 75 

vitreous and positive being used synonymously, as are resi- 
nous and negative. 

What relation do substances bear to each other, similarly 
electrified? They repel each other. 

When dissimilarly electrified ?- They attract each other. 
How is electricity excited ? By chemical and mechanical 
means; when excited by chemical means, it is called gal- 
vanism. 

What is a simple galvanic circle ? It is a plate of zinc, 
and a plate of copper placed in a vessel of water, and the two 
metals are made to touch each other directly or by the inter- 
vention of a wire, and galvanism is excited. 

What are compound galvanic circles?- Series of simple 
circles. 

For more full explanations see works devoted particularly 
to these subjects. 

Specific Gravity. 

What is specific gravity? It is the relative weight of 
equal bulks of different booties. 

How is it ascertained? By dividing the weight of the 
body, by the weight of the same bulk of water, which is as- 
sumed as unity. 

How is the weight of a like bulk of water found? By 
weighing the substance out of water, and in water, the dif- 
ference will be the weight of the water displaced. 

Suppose the body is lighter than water? Then add the 
weight necessary to sink it to the weight of the body, and 
you have the weight of an equal bulk of water, which will 
enable you to find the specific gravity in the usual manner. 

What are the instruments used to ascertain the specific 
gravity of liquids ? Hydrometers. 

What is assumed as unity in ascertaining the specific gra- 
vity of gases? The atmospheric air; and their specific 
gravity is ascertained on the same principle as liquids and 
solids. 

Nomenclature. 

What are the compounds of oxygen called, that do not pos" 
sess acidity? Oxides. 

What are they called when they possess acidity? Acids; 
and are named from the substance acidified by the addition 
of ic. For instance, sulphuric and carbonic acids are acid 
compounds of sulphur, and carbon with oxygen. 



76 



CHEMISTY. 



Suppose a base should form two acids with oxygen, what 
is the one called containing the least quantity of oxygen? 
It takes the name of the base with the addition of ous, 
as sulphurous acid. 

By what name do wo denote the simple non-metalic com- 
bustibles when united with one another, with a metal, or a 
metalic oxide? They are known by the addition of uret, 
as sulphuret, carburet, and phosphuret of iron, which de- 
notes compounds of sulphur, carbon, and phosphorus with 
iron. 

How are the oxides distinguished from each other"? Pro- 
toxide is the first degree of oxidation; binoxide the second; 
teroxide the third; and the term peroxide is often applied to 
the highest degree of oxidation. Sesqui, one and a half, is 
used to an oxide the oxygen in which is to that in the first 
oxide, as one and a half to one, or as three to two. 

What is usually understood by the term salt? A com- 
pound resulting from the union of an acid with a base. The 
definition of a salt, as given by Dr. Hare, is that it is a 
soluable compound, containing one or more acids, or cor- 
rosive ingredients, the qualities of the ingredients being 
either neutralized, or modified; the name is indicative of 
the composition. 

If the acidified substance contains a maximum of oxygen, 
the name of the salt terminates in ate; if a mininum in ite. 
Thus the sulphate, carbonate, arseniate of potassa are salts 
of sulphuric, carbonic, and arsenic acids, with potassa. The 
terms sulphite, and arsenite of potassa, denote combinations 
of sulphurous, and arsenous acids with potassa. 

What is understood by neutral, super, and sub salts? 
Salts are termed neutral, if the acid and alkali neutralize 
each other; super, if the acid is in excess; and sub if the 
alkali is in excess. 

Another manner of expressing the relation between acids, 
and bases relates to the atomic constitution of the salt. If 
there is an equivalent of the acid, and alkali, the generic 
name of the salt is employed without any other addition. 

If two or more equivalents of the acid are attached to 
one of the base, a numeral is prefixed indicating its compo- 
sition, as the sulphate, and bisulphate of potassa; the 
oxalate, binoxalate, and quadroxolate of potassa. When 
the base is in excess, or the acid deficient, it is proposed to 
use the Greek numerals, dis, tris, tetrakis, to indicate the 



CHEMISTRY. 



equivalent of an alkali in a subsalt. In other compounds 
where two or more equivalents of a negative element enters, 
they are distinguished by the Latin numeral, and the Greek 
numerals are applied to that element regarded as positive, 
For instance, a bichloride contains two equivalents of the 
negative element chlorine : on the other hand, a dichloride 
signifies that one equivalent of chlorine is combined with 
two of a positive body. 

Affinity. 

What is understood by chemical affinity, or attraction? 
It is that affinity, or attraction which is exerted between 
the minutest particles of different kinds of matter, causing 
them to combine, and form new bodies, with new properties. 

Does it act at sensible or insensible distances? It acts 
only at insensible distances, or when in apparent contact. 

What is an instance of chemical attraction? When wo 
mix water and alcohol, or water and sulphuric acid, a 
union takes place, which is an example in question. 

What is understood by single elective affinity? Sup- 
pose we have a compound formed by the union of ammo- 
nia and oil, and to this we add sulphuric acid, the greater 
attraction of the ammonia for the sulphuric acid than 
exists between it and the oil, will cause it to leave the oil, 
and unite with the acid: this is an instance of single elec- 
tive affinity; so termed, because there appears to be an 
election, or choice exercised. 

What is meant by double elective affinity? Supposo two 
salts having different acids and bases; say carbonate of 
ammonia, and hydrochlorate of lime bo mixed together, the 
carbonic acid will quit the ammonia, and unite with the 
lime; the hydrochloric acid will also leave the lime, and 
unite with the ammonia; so that both original salts will be 
decomposed, and two new ones formed; this is an instance 
of double elective affinity. The affinity which tends to 
resist a change is called* quiescent affinity, and the one 
which tends to produce it is called divellent affinity. 

What leading circumstances characterize chemical a ction ? 
The loss of properties of the combining substances, and 
the acquisition of new ones in the new compound; changes 
of density, temperature, form, and color. 

What circumstances modify the operation of affinity 7 
Cohesion, elasticity, quantity of matter,- gravity, pressure of 
the atmosphere, and the agency of the imponderables. 



78 



CHEMISTRY. 



Do bodies unite in definite or indefinite proportion - ? 
Most bodies in forming chemical combinations unite in 
definite proportions. Some unite indefinitely, but with a 
feeble affinity. 

What is understood by chemical equivalent] It is a 
number representing the loast combining proportions of a 
body, which is equivalent to another body, and may be sub- 
stituted for it in combinations. These combining propor- 
tions may be expressed by numbers, in which hydrogen is 
represented as 1, and they represent relative, and not abso- 
lute weights. 

What is meant by isomeric bodies? Bodies are termed 
isomeric which contain the same chemical elements, and in 
the same ratio, and yet have chemical properties different 
from each other. . 

How may the equivalent of compounds be determined ) 
By adding together the numbers representing the equiva- 
lents entering into the combination. These numbers aro 
sometimes termed atomic weights. 

Oxygen. 

How is oxygen obtained? It may be obtained from the 
peroxides of manganese, lead, and mercury, nitre, and 
chlorate of potash, by exposure to a red heat. It may be 
obtained from the former by heating it to redness in a gun 
barrel, or heating it in a flask with an equal weight of con- 
centrated sulphuric acid, by means of a lamp. 

What is the rationale of these two last processes'? On 
applying a red heat to the peroxide of manganese it parts 
with half an equivalent of oxygen, and is converted into the 
sesquioxide. 

When mixed with sulphuric acid the peroxide looses a 
whole equivalent of oxygen, and is converted into the pro- 
toxide which unites with the acid, leaving a sulphate of the 
protoxide in the retort. 

What is the rationale when procured from the chlorate of 
potash? A retort of glass containing no lead in its compo- 
sition should be used. The chlorate first becomes liquid, 
and on an increase of heat is wholly resolved into pure 
oxygen gas, which escapes, and into a white compound 
which is the chloride of potassium, and remains in the 
retort. The oxygen is therefore derived partly from the 
potassa, and partly from the chloric acid. Procured in this 
way it is very pure. 



CHEMISTRY. 



What are the properties of oxygen gas? It is colorless* 
insipid, inodorous, refracts light feebly, a non-conductor of 
electricity, the most perfect electro-negative substance we 
possess, heavier than atmospheric air, unites with some sub- 
stances which are said to be oxidized, and are divided into 
oxides and acids, supports combustion in a high degree, 
and necessary in a diluted state to the respiration of animals; 
pure it is deleterious. Its specific gravity is 1.102; equiv- 
alent 8; and symbol O. 

What is understood by combustion? In its common ac- 
ceptation it means the rapid union of oxygen with a com 
bttstible material, attended with the emission of light and 
heat. But the union of many other substances are also 
characterized by similar phenomena. 

Hydrogen. 

How is hydrogen procured ? It may be procured tolera- 
bly pure by passing the vapor of water over metalic iron, 
heated to redness, and by putting pieces of iron or zinc into 
dilute sulphuric acid. 

What is the rationale of these processes? In the former 
case the oxygen of the water unites with the red hot iron and 
the hydrogen is set at liberty. In the latter, the oxygen of 
the water unites with the metal, and forms an oxide, which 
unites with the acid, and forms a sulphate while the hydro- 
gen of the water is set at liberty. 

What are the properties of hydrogen gas? It is colorless, 
neither odor or taste, a powerful refractor of light, the light- 
est body known, will not support respiration, a non-support- 
er of combustion, highly inflammable, but like other com- 
bustibles requires the aid of a supporter of combustion, and 
produces a remarkable alteration in the voice when 
breathed. If a jet be thrown upon spongy platinum, it is 
ignited. Its equivalent is 1 ; symbol H. 

What is the product in the combustion of hydrogen? 
Water; which will be exactly equal in weight to the gases 
disappearing. 

What is the proportion existing between the oxygen and 
hydrogen in the formation of water? By measure there is 
two volumes of hydrogen to one of oxygen: by weight 88.9 
oxygen to 11.1 hydrogen, or nearly as 8 parts oxygen to 1 of 
hydrogen. Its symbol is H. O. 

How many combinations are there of oxygen, and hydro ^ 



CHEMISTRY, 



gen? Two; one in the proportion to form water, and anoth- 
er which is the peroxide of hydrogen, and contains twice as 
much oxygen as is contained in water. 

Nitrogen or Azote. 

How is nitrogen procured? By burning a piece of phos= 
phorusin ajar full of air, inverted over water; the oxygen 
of the atmosphere unites with the phosphorus forming me- 
ta-phosphoric acid which is absorbed by the water. Nitro- 
gen remains in the jar in combination with a small quantity 
cf carbonic acid, which may be removed by agitating it 
with a solution of pure potassa. Or it may be procuredTby 
any other substance which will take the oxygen from the 
atmosphere, and leave the nitrogen. 

What are the properties of nitrogen? It is colorless, de- 
void of taste or smell, more distinguised by negative charac- 
ters than by any striking properties; non-supporter of com- 
bustion and respiration, and not combustible. Its equiva- 
lent is 14; sp. gr. 0.689; symbol N. 

How many compounds does nitrogen form with oxygen? 
Five, besides its combination in the atmosphere, wmich is 
considered as a mechanical mixture. They are the nitrous 
oxide, nitric oxide, hyponitrous acid, nitrous acid, and nitric 
acid. The first is one atom of oxygen to one of nitrogen; 
the second, two of oxygen; the third, three; &c. 

What is understood by the air or atmosphere ? It is that 
mass of gaseous matter by which the earth is surrounded 
on all sides, and adheres to it by the force of gravity. Its 
pressure on the surface of the earth is equal to about 15 
pounds to the square inch of surface, which renders it 
capable of supporting a column of water 34 feet high, and 
one of mercury 30 inches. 

Is the pressure of the atmosphere invariably the same? 
No, it varies at different times, and according to the eleva- 
tion above the level of the sea, as indicated by the barome- 
ter. 

What are the component parts of the atmosphere? It is 
composed of oxygen 20 or 21 parts; and nitrogen 79 or 80 by 
volume; it also contains a little carbonic acid. The princi- 
pal chemical properties are owing to the presence of oxy- 
gen. 

How is the protoxide of nitrogen or nitrous oxide procur- 
ed? By subjecting the nitrate of ammonia to heat, which 



CHEMISTRY 



81 



is decomposed, and the products are protoxide oi nitrogen, 
and water. 

What is the rationale of this process ? The nitrate of 
ammonia is composed of nitric acid, and ammonia. The 
nitric acid is composed of one equivalent of nitrogen, and 
five of oxygen, and the ammonia, of one of nitrogen, and 
three of hydrogen, making in all two equivalents of nitro- 
gen, five of oxygen, and three of hydrogen. By the addi- 
tion of heat their relations are changed, so that the three 
equivalents of hydrogen unite with three of tho oxygen, 
and form water, leaving two equivalents of oxygen, and two 
of nitrogen, which unite, and form tho nitrous oxide. 

What are the properties of nitrous oxide ? It is a color- 
less gas, absorbable by pure water, a supporter of combus- 
tion, produces exhileration when breathed, without being fol- 
lowed by depression or languor. 

How is the binoxido procured ? By the action of nitric 
acid on metalic copper; the gas escapes, and may be col- 
lected over water, or mercury. 

What is the rationale of this process ? Ono portion of ni- 
tric acid is decomposed; part of its oxygen oxidizes the cop- 
per, while another part is retained by the nitrogen, forming 
the binoxide or nitric oxide. 

What are the properties of tho binoxide of nitrogen? It 
is a colorless gas; when mixed with any gaseous mixture 
containing oxygen dense suffocating acid vapors of a red or 
orange color are produced, which are nitrous acid, and arc 
copiously absorbable by water. This peculiarity is a distin- 
guishing test for nitric oxide, and is also a test for the pres- 
ence of free oxygen. It is not possessed of acid properties, 
and is irrespirable. 

How is hyponitrous acid produced? By adding binoxide 
of nitrogen to oxygen in excess, pure potash being present, 
100 measures of oxygen combine with 400 of the binoxide, 
and hyponitrous acid is formed, which unites with the pot- 
ash. 

What are its properties? At 0° F., anhydrous liquid hy- 
ponitrous acid is colorless, and green at common tempera- 
tures, very volatilo, passing off in the form of an orange va- 
por; on admixture with water it is converted into nitric acid, 
and binoxide of nitrogen. 

How is nitrous acid obtained? By introducing 200 
measures of binoxide of nitrogen into a dry exhausted glass 
8 



82 CHEMISTRY, 

vessel, with 100 of oxygen; also by subjecting the nitrate 
of lead, carefully dried, to a red heat. 

What are its properties'? Its vapor is of an orange red 
color, irrespirable, has acid properties, is absorbed by water, 
the binoxide of nitrogen being disengaged, and nitric acid 
remains in the water. Its vapor may be condensed by a 
freezing mixture, into a liquid, in which state, it is anhy- 
drous acid, and pungent to the taste, gives a yellow stain to 
the skin, aud is very corrosive. At 0° it is nearly colorless, 
and at 32° it is yellow. When mixed with a considerable 
quantity of water, it is instantly resolved into binoxide of ni- 
trogen, which escapes with effervescence, and into nitric 
acid which unites with the water. 

How may nitric acid be procured? By adding binoxide 
of nitrogen slowly over water, to an excess of oxygen gas. 
It is composed of 100 measures of nitrogen, and 250 of oxy- 
gen. For commerce it is procured by decomposing some 
salt of nitric acid with oil of vitriol; and common nitre or 
saltpetre is generally employed. 

Can nitric acid exist in an insulated state? No; it exists 
only in combination with water, which, in its concentrated 
form is the nitric acid of the shops. In commerce it is gen- 
erally known by tho name of aqua fortis. 

What are its properties? It is highly acid, largely dilut- 
ed it reddens litmus paper permanently, unites with alkalies 
forming salts, which are called nitrates. In its purest con- 
centrated form it is colorless, and has a specific gravity of 
1.5 or 1.51. At 1.5 it contains 20 per cent, of water, for 
which it has a great affinity, acts powerfully on substances 
disposed to unite with oxygon, decomposes vegetables, the 
oxvgen of the acid uniting with their hydrogen, farming 
water, and also with the carbon, form mg carbonic acid. All 
the salts of nitric acid are soluble in water. 

What are the tests for nitric acid, and the nitrates? 
When uncombined, it is readily detected by its strong ac- 
tion on copper and mercury, emitting ruddy fumes of ni- 
trous acid. 

Another, is to mix the supposed nitric acid, or nitrate, 
with dilute sulphuric acid, add to this some pure zinc, and 
set fire to the hydrogen as it is evolved; if nitric acid is pre- 
sent the flame will have a greenish white tint, which is ow- 
ing to the presence of the binoxide of nitrogen. 
- Another, is to add to the supposed nitrate a drop of 



CHEMISTRY. 



sulphuric acid heated in a test tube, and then add a ehry stal of 
morphia, which, if nitric acid bo present, will become of an 
orange-red followed by a yellow color. The sulphuric acid 
in this case, should also be tested previously. 

Carbon. 

In what form is carbon usually presented to us) In the 
form of charcoal. 

How is it procured? By heating wood to redness in a 
close vessel. The volatile parts are, expelled, and the carbo- 
naceous part remains, which is called charcoal. If bones are 
used instead of wood, we have animal charcoal, or ivory black. 

What are tho properties of charcoal ?- It is highly com- 
bustible, hard, and brittle, conducts heat slowly, a good con- 
ductor of electricity, very refractory in the fire if the air is 
excluded, absorbs air, or other gases largely, and yields 
them again on the application of heat; the proportion, how- 
ever, varying in different gases, and absorbs the odoriferous 
and coloring particles of animal and vegetable substances. 

Animal charcoal is mostly used when we wish to decolor- 
ize fluids, by being finely pulverized, and having the fluid 
filtered through it. The equivalent of carbon is 6.12 sym. C. 

What are the compounds of carbon and oxygen? There 
are two; carbonic oxide, which is one equivalent of each; 
and carbonic acid, which is two equivalents of oxygen, and 
one of carbon. 

How is carbonic acid or fixed air procured? It may be 
expelled from common limestone, or magnesia, (which are 
carbonates), by the action of heat, or acids. It is also form- 
ed during respiration, fermentation, and combustion. 

What are the properties of carbonic acid? It is colorless, 
inodorous, elastic, condensiblc into a liquid under apressuro 
of 36 atmospheres, may be frozen into a white solid, will 
not support respiration, or combustion, incombustible, ren- 
ders lime water turbid by the formation of carbonate of lime, 
absorbable by water, the quantity absorbed being very much 
increased by pressure; and when the pressure is removed it 
escapes with an effervescence. The agreable lively taste of 
beer, porter, ale, &c, is owing to its presence. It unites with 
alkaline substances, and the salts so formed, are termed car- 
bonates. It is easily displaced from all its combinations by 
the hydro-chloric and the stronger acids, when it escapes 
with effervescence, 



§4 



CHEMISTRY. 



How is carbonic oxide procured? By exposing two parts 
of well dried chalk and one of pure iron filings to a red heat, 
and washing the gas evolved with lime water, or an alka- 
line solution, which absorbs the carbonic acid, and leaves 
the carbonic oxide. 

Another mode is to mix binoxalate of potash with five 
or six times its weight of sulphuric acid, and heat it in a re- 
tort; an effervescence soon ensues, which is a mixture of 
carbonic acid and carbonic oxide, and may be separated in 
the same manner as in the preceding process. 

What is the rationale of this last process? Oxalic acid is 
a compound of equal parts of the elements of carbonic acid 
and carbonic oxide, and they cannot exist in the form of ox- 
alic acid, unless in combination with water, or some other 
substance. The sulphuric acid then unites with both the 
potassa and water of the binoxalate, and the oxalic acid be- 
ing thus set free, is decomposed. 

What are the properties of carbonic oxide'? It is color- 
less, insipid, has no acid properties, inflammable, burning 
with a lambent blue flame, and irrespirable. 

Sulphur. 

In what form do we generally find sulphur? It is found 
in the region of volcanoes, generally in a massive state, 
sometimes crystalized; it is also found combined with the 
metals, such as silver, copper, antimony, lead, and iron. 
From its combination with iron, which is called iron pyrites, 
it may be procured in large quantities by exposure to a red 
heat in a close vessel, when it is sublimed. 

What are the properties of sulphur? It is solid, brittle, 
of a greenish yellow color, has a peculiar odor when rubbed, 
tasteless, crystallizable, a non conductor of electricity, 
negatively electrified by friction, fused at 216° F, ; if the 
temperature is raised to 320° it thickens and acquires a 
reddish tint, at 428° to 482 p it is so tenacious that the ves- 
sel may be inverted without causing it to change its place, 
if raised still higher to its boiling point it again becomes 
liquid; at the temperature of 428° 4 if poured into water 
it becomes ductile. It is volatile at' 550° to 600°, and is 
condensed unchanged at lower temperatures. Its equiva- 
lent is 16.1; symbol S ; specific gravity 1.99. 

What are the compounds of sulphur and oxygen. There 
are four: sulphurous acid, which is 1 eq, of sulphur, and 2 



CHEMISTRY. 



85 



eq. of oxygen: sulphuric acid, which is 1 eq. of sulphur, 
and 3 eq. of oxygen : hyposulphurous acid, which is 2 eq. 
of sulphur, and 2 eq, of oxygen: and tho hyposulphuric 
acid, which is 2 eq. of sulphur to 5 eq. of oxygen, 

What are the properties of sulphurous acid? It is gas- 
eous, colorless, transparent, has a pungent suffocating odor, 
an acid taste, and bleaching properties; it reddens litmus, 
at first, and then bleaches it. It has a strong affinity 
for oxygen, and will precipitate metals which have a 
weak affinity for oxygen from their solutions. It com- 
bines with metalic oxides, and forms salts called sulphites. 

How is it procured ? It is formed by the combustion of 
sulphur in the atmosphere or dry oxygen gas; it is also 
evolved mixed with carbonic acid when combustible sub- 
stances containing carbon are heated with strong sulphuric 
acid; and by heating sulphuric acid with most of tho 
metals; with copper and mercury particularly, it yields 
a very pure gas. It may be obtained liquid, by transmitting 
dry pure gas through a glass tube surrounded by a freezing 
mixture. When exposed to cold in a moist state a crys- 
talline solid is formed. 

HoW is sulphuric acid procured? One method is to sub- 
ject to a strong heat the sulphate of iron, (copperas or green 
vitriol;) the sulphuric acid of the salt passes over in com- 
bination with the water which it contains. 

Procured in this way it is called the fuming sulphuric 
acid of Nordhausen, on account of tho white vapors which 
it emits on exposure to the air, and from the place in Ger- 
many where it is manufactured. 

Anhydrous sulphuric acid may be procured from this by 
heating it gently in a retort, and surrounding tho receiver 
adapted to it with a mixture of snow and salt, in which it 
is condensed into a white crystalline solid. 

The most common process for procuring sulphuric acid 
is to burn sulphur mixed with I its weight of nitrate of 
potash, in a furnace arranged so that the current of air, sup- 
porting combustion will conduct the products into a leaden 
chamber containing water, which becomes saturated with 
the sulphuric acid formed in the process. 

What is the rationale of this process? The nitric acid 
of the nitre yields oxygen to a portion of sulphur, and con- 
verts it into sulphuric acid, which combines with the potassa 
of the nitre; at the same time the greater part of the sul= 

8* 



80 CHEMISTRY. 

phur forms sulphurous acid by uniting with the oxygen of 
the air. 

The nitric acid by yielding a portion of its oxygen to the 
sulphur, is converted into binoxide of nitrogen; which 
coming in contact with the air at the moment of its separa- 
tion is converted into red nitrous acid vapors. The gase- 
ous product in the leaden chamber therefore is sulphurous, 
and nitrous acids, atmospheric air and watery vapor. From 
these elements a crystalline compound is formed consist- 
ing of sulphuric acid, hyponitrous acid and water; and 
when this solid comes in contact with the water of the 
chamber it is decomposed, the sulphuric acid is absorbed 
by the water, and nitrous acid, and binoxide of nitrogen 
escape, the latter of which coming in contact with the air, 
is converted into nitrous acid. This nitrous acid is again 
intermixed with sulphurous acid and aqueous vapor, and 
gives rise to a second portion of the crystalline compound 
which undergoes the same changes as the first. 

What aro the properties of sulphuric acid? As usually 
obtained it is a dense, colorless, oily fluid; boils at 620°; 
specific gravity 1.847; very corrosive; sour, reddens litmus, 
and separates all other acids from their union with the alka- 
lies. Chloride of barium is a test for it, and will form a 
white precipitate, the sulphate of baryta. 

Phosphorus, 

How is phosphorus procured? By igniting bones in an 
open fire until all the animal matter is destroyed, leaving 
only a white substance, which is principally the phosphate of 
lime; reduce this to a fine powder, and digest with strong 
sulphuric acid and water, sufficient to give the consistence 
of a thin paste. The phospahte of lime is decomposed; a 
sulphate, and a soluble super-phosphate of lime is formed. 
The super-phosphate of lime is to be dissolved in warm 
water, and separated from the sulphate by filtration, and 
evaporated to the consistence of syrup, then mixed with i 
its weight of powdered charcoal, and heated in an earthen 
retort, with the beak of the retort put into water, in which 
the vapor of the phosphorus is condensed, of a reddish 
brown color, owing to the presence of the phosphuret of 
carbon. It may be purified by a second distillation. 

What is the rationale of this process 1 When the super- 
phosphate of lime and charcoal are mixed, and heat applied, 



CHEMISTRY. 



the oxygen of that part of tho phosphoric acid which con- 
stitutes the superphosphate unites with the charcoal and 
forms carbonic acid, and carbonic oxide gases; phosphorus 
is distilled over, and phosphate of lime with redundant char- 
coal remains in the retort. 

What are the properties of phosphorus'? It is colorless, 
and transparent when pure; a soft solid at ordinary temper- 
atures, has a waxy lustre when cut with a knife, distills at 
550°, very inflammable, undergoes slow combustion at com- 
mon temperatures when exposed to the air, and emits a white 
vapor of an alliaceous odor. Its equivalent is 15.7; symbol 
P; and sp. gr. 1.77. 

What are the compounds of phosphorus and oxygen? The 
oxide of phosphorus, consisting of three equivalents of phos- 
phorus, and one of oxygen; the hypophosphorus acid, 2 
eq. of phosphorus to 1 of oxygen; the phosphorus acid, 2 
eq. of phosphorus to 3 of oxygen; and the phosphoric, pyro- 
phosphoric, or metaphosphoric acid, which is 2 eq. of phos- 
phorus and 5 eq. of oxygen. 

How is phosphoric acid procured? By decomposing phos- 
phate of baryta with sulphuric acid. 

What are its properties'? It is viscid, inodorous, colorless, 
liquid, reddens vegetable blues, and when heated to redness 
corrodes glass or porcelain. 

What is paraphosphoric or metaphosphoric acid? It is 
formed when phosphoric acid is heated to redness and al- 
lowed to cool Paraphosphoric, metaphosphoric and pyro- 
phosphoric acid are isomeric bodies because they consist of 
the same proportions of the same elements but differ in pro- 
perties. 

Boron. 

How is boron procured? It was first obtained by subject- 
ing boracic acid to the action of a powerful galvanic battery. 
But it may be procured in larger quantities by heating 
boracic acid with potassium, by which the boracic acid is 
deprived of its oxygen, and the boron liberated. 

What are the properties of boron? It is of a dark olive 
color, has neither taste nor smell, and is a nonconductor of 
electricity. It is not soluble in water, alcohol, ether, or oils, 
does not decompose water, bears a strong heat in close ves- 
sels without fusing, or being changed, except that its density 
is increased. If Seated to" 600° it takes fire, oxygen disap- 



88 



CHEMISTRY. 



pears, and boracic acid is formed. Its equivalent is 10,9; 
symbol B; sp. gr. about % 

What are the compounds of boron and oxygen? Boracic 
acid is the only compound of boron and oxygen. 

Where is it found and how is it procured? It is found 
as a natural product in some of the hot springs, and is a con- 
stituent of datolite, boracite, and borax, whiten is a compound 
of boracic acid and soda. It is procured by adding sulphuric 
acid to a solution of purified borax in four times its weight 
of boiling water. The sulphuric acid unites with the soda 
and the boracic acid is deposited on cooling in crystals 
which may be purified by washing, dissolving them in boil- 
ing water and by rocrystalization. 

What are the properties of boracic acid? In crystals it is 
a hydrate, slightly soluble in water, very soluble in alcohol, 
and the solution when set on fire burns with a green flame 
which is a sure test for the presence of boracic acid; sp. gr. 
1.479. inodorous, bitter taste, reddens litmus, and with al- 
kaline carbonates produces efTervesence. In its hydrous 
state if gradually exposed to a high heat its water of crys- 
talization is expelled and a fused mass remains, which will 
bear a white heat without sublimation, and on cooling forms 
a hard transparent glass which is anhydrous boracic acid. 
It absorbs water, and looses its transparency if exposed to 
the air. It is sometimes used as a flux from its being very 
fusible and communicating this property to other substances. 

Silicon. 

How is silicon procured? It was first procured by Ber- 
zelius, by the action of potassium on fluo-silicic acid gas ; but 
a more convenient process is from the double fluoride of sili- 
con, and potassium, or sodium, previously dried, and placed 
in a glass tube with potassium, to which a spirit lamp is 
applied. The potassium uniting with the fluorine and the 
silicon is set at liberty. To render it perfectly pure it should 
then be heated to redness, and digested in dilute hydro- 
fluoric acid. 

What are the properties of silicon ?, It is of a dark nut 
brown color, without metalic lustre non-conductor of elec- 
tricity, incombustible, not dissolved or oxydized by sul- 
phuric, nitric, hydrochloric or hydrofluoric acids; but nitric 
and hydrofluoric acids mixed dissolve it readily. Its equiv- 
alent is 22,5; symbol Si. 



CHEMISTRY. 



What is the composition of silicic acids] In 100 parts 
there are 48.4 of silicon, and 51.6 oxygen, by weight. 

Where is the silicic acid found, and how is it procured? 
It exists in great profusion in nature, under the names of 
silica and silicious earths. It forms a part of many miner- 
als, and under the name of quartz forms mountainous 
masses. It is the principal ingredient in sand stones, flint, 
calcedony, &c, &c. It may be procured by igniting pure 
rock chrystal, throwing it while red hot into water, and re- 
ducing it to a fine powder. 

What are the properties of silicic acid"* As procured 
above it is a light white powder, feels rough and dry when 
rubbed between the fingers, insipid and inodorous; sp. gr. 
2,69. It is very fixed in the fire, but may be fused by the 
hydro-oxygen blow pipe, insoluble in water, does not affect 
tests for acids, but in its chemical combinations acts the 
part of an acid, and displaces carbonic acid from the alka- 
lies by the aid of heat. The nature of its combinations 
with the alkalies depends upon the proportions in which 
they are united. One of these combinations which is ono 
part silicic acid, and three of carbonate potassa, is deliques- 
cent and easily dissolved in water, in this condition it has 
been called the liquor of flints or liquor silicum. 

By reversing the proportions the result is the well known 
article glass. Every kind of glass is a compound of silicic 
acid with a base, or bases; therefore a silicate. The qual- 
ity generally depending upon the purity of the materials, 
and in flint glass, besides the pure silicic acid and alkali, 
there is added some of the oxides of lead; it is therefore a 
double salt, composed of bisilicate of potassa, and bisili- 
cate of oxides of lead. It equivalent is 46.5. 

Selenium. 

How is selenium formed, and how is it procured? It 
generally occurs in combination with iron pyrites, also in 
some volcanic products, as a sulphuret, and it is sometimes 
found combined with several of the metals. It may be ob- 
tained from the sulphuret by mixing it with eight times its 
weight of peroxide of manganese, and exposing the mix- 
ture to a low red heat in a glass retort, the beak of which 
extends into water. The sulphur is oxidized by the oxide 
of manganese, and the selenium is sublimed. 

What are its properties? It ia a brittle opaque solid, 



90 



CHEMISTRY, 



having neither taste or odor, of a metalic lustre when in 
mass, and when in powder of a deep red color. It softens 
at 212°, and may be drawn into fine threads; conducts heat 
and electricity imperfectly, and is insoluble in water. Ex- 
posed to the flame of a blow pipe it colors the flame of a 
light blue color, and exhales a strong odor of decayed horse 
radish; which maybe considered as characteristic of the 
presence of selenium, whether alone or in combination. Its 
equivalent is 39.6; symbol So. 

What are the compounds of selenium and oxygen? 
There are three ; the oxide of selenium, which is 2 eq. of 
selenium to 1 of oxygen; selenious acid, 1 eq. selenium to 
2 of oxygen; and selenic acid, 1 eq. selenium to 3 of oxy- 
gen. The selenic acid is analagous in composition, and 
many of its properties, to sulphuric acid, and that similarity 
extends also to their compounds with alkaline substances. 

Chlorine. 

How is chlorine gas obtained? By the action ot hydro- 
chloric or muriatic acid, and the peroxide of manganese in 
the proportion of two parts of the former to one of the lat- 
ter; the chlorine escapes with effervescence, without the 
application of heat; but much more rapidly when heat is 
applied. 

What is the rationale of this process? The hydrochloric 
acid consists of chlorine 2 eq., and hydrogen 2 eq.; the 
oxide of manganese consists of manganese 1 eq., and ox- 
ygen 2 eq. In the reaction which takes place 1 eq. of chlo- 
rine unites with the 1 eq. of manganese, forms the chloride 
of manganese, and 1 eq, of chlorine is set at liberty; and 
the 2 eq. of oxygen and 2 eq. of hydrogen unite and form 
water, So that the result is chloride of manganese, water, 
and chlorine, which is set at liberty. 

What are the properties of chlorine gas? It has a yel- 
lowish green color, astringent taste, and disagreeable smell. 
It is irrespirable even if largely diluted with air, and emits 
heat and light when strongly compressed. By the applica- 
tion of about four atmospheres of pressure, it becomes a 
limpid liquid of a bright yellow color. It is absorbable by 
water, which yields it when heated. It presents the phe- 
nomena of combustion when brought in contact with some 
substances, and the result is a chloride, or an acid contain- 
ing chlorine. It has a very strong affinity for hydrogen, is 



CHEMISTRY. 



91 



negatively electric, has no acid properties, has a great affin- 
ity for metals, and a powerful bleaching property. In its 
application to bleaching the presence of water is necessary, 
and hydrochloric acid is generated during the process; from 
which we infer that the water is decomposed, the hydrogen 
uniting with the'chlorine, and the oxygen is liberated, which 
occasions the bleaching. The compounds of chlorine 
which are not acid are termed chlorides. The test for 
chlorine is nitrate of the oxide of silver, which produces a 
white precipitate. Its equivalent is 35.42; symbol CI ; sp. 
gr. 2.47. 

What compound does chlorine form with hydrogen] It 
forms the hydrochloric or muriatic acid, which is 1 eq. of 
chlorine to 1 of hydrogen. 

How may this acid be prepared? In a gaseous state it 
may be procured by putting a strong liquid solution of the 
acid into a glass, and heating it until it boils, when the gas 
is evolved, and may be collected over mercury. Another 
method is to mix equal weights of liquid sulphuric acid and 
sea salt, and apply heat. 

What is the rationale of these processes? In the former 
the acid dissolved in water is simply expelled by heat. 

In the latter the water is decomposed, its oxygen unites 
with the sodium of the chloride of sodium or sea salt, and 
forms soda; the hydrogen unites with the chlorine and forms 
the hydrochloric acid which escapes, and the sulphuric acid 
unites with the soda. The water in this process is sup- 
plied by the sulphuric acid. The result therefore is sul- 
phate and bisulphate of soda, and hydrochloric acid. 

Under what circumstances will the elements of hydro- 
chloric acid when brought into contact unite? When an 
electric spark is passed through the mixture, by the pres- 
ence of flame, a red hot body, or spongy platinum. By 
exposure to diffused light they unite slowly, but the direct 
solar rays like electricity, flame, &c, produce a sudden 
inflammation accompanied with an explosion. 

In what manner is the acid procured in a liquid state? 
By passing a current of gas into water as long as any of it will 
be absorbed, wo- procure a concentrated aqueous solution. 

What are the properties of hydrochloric acid? In a gase- 
ous state it is colorless, has a, pungent odor, and an acid 
taste. In a temperature of 50°, and under a pressure of 40 
atmospheres, it. is liquid. It is irrespirable, incombustible, 



92 



CHEMISTRY. 



and a non supporter of combustion. Heat will not alter it 
chemically, but galvanism will decompose it; hydrogen will 
be found at the negative pole, and chlorine at the positive. 
It has a powerful attraction for water, which causes a white 
cloud to appear, where it is liberated into the atmosphere, 
owing to its combination with the aqueous vapor; ice, also 
liquifies instantly, if introduced into a jar containing it, and 
the gas is rapidly absorbed. On introducing ajar contain- 
ing the gas into water, the absorption takes place so rapidly, 
that the water is forced up with the same rapidity as if it 
were a vacuum. During the absorption, heat is given out. 

How can we determine the quantity of this acid contain- 
ed in its solutions'? By ascertaining the quantity of pure 
marble dissolved by a given w r eight of each. Every 50.6 grs. 
of marble correspond to 36.42 of real acid. 

What are the properties of the hydrochloric acid of com- 
merce? It has a yellow color, and contains impurities, 
which are usually nitric and sulphuric acid, and the ox- 
ide of iron. If pure, it is a colorless, liquid, emits white va- 
pors if exposed to the air, very sour, reddens litmus, and 
neutralizes alkalies. It freezes at 60°, and boils at 110° giv- 
ing off the pure hydrochloric acid gas freely. 

It is decomposed by substances yielding oxygen easily. 

What combination of hydrochloric acid is used in dissolv- 
ing gold, and platinum 1 It is a mixture of two parts of the 
hydrochloric, and one of the nitric acids, and is commonly 
termed aqua regia. 

What chemical action takes place in forming a solution 
of gold by this mixture 1 ? The nitric and hydrochloric acids 
decompose each other, and produce water, nitrous acid, and 
chlorine; the solvent power is dependent on the chlorine, 
which is liberated. 

What are the compounds of chlorine, and oxygen? They 
are; the hypochlorous acid, 1 eq. by weight of each, the 
chlorous acid; 1 eq. chlorine to 4 oxygen; the chloric acid, 
1 eq. chlorine to 5 oxygen; and the perchloric acid, 1 eq. 
chlorine to 7 oxygen. 

How is hypochlorous acid procured? Hypochlorous acid, 
or euchlorine, may be best procured by pouring peroxide of 
mercury in fine powder, and mixed with twice its weight of 
distilled water, into bottles filled with chlorine gas. By agi- 
tation, the chlorine is completely absorbed. The oxide of 
mercury is decomposed, both its constituent? combining 



CHEMISTRY, 



93 



with chlorine, the mercury forming corrosive sublimate, and 
tho oxygen hypochlorous acid. The acid may then be sep- 
arated by distillation, which should be done at a tempera- 
ture below 212°, as it is decomposed at that heat; or it may 
be best performed under reduced pressure. The acid thus 
procured, may be concentrated by a second distillation. 

What are the properties of hypochlorous acid? It is a 
transparent liquid of a slightly yellow color when concen- 
trated; has a strong penetrating odor, an exceedingly active 
action on the skin, similar, but greater than that of nitric 
acid; high bleaching properties, when concentrated very lia- 
ble to be decomposed, chlorine being evolved, and chloric 
acid produced; this effect is promoted by light, and produc- 
ed instantly by the direct rays of the sun; also, by agitation 
with angular bodies; a portion of pounded glass produces 
brisk decomposition, when thrown into this acid. It is a 
powerful oxidizing agent, particularly of the non metalic 
elements which are readily brought to their highest degree 
of oxidation. 

How is chlorous acid procured? By making 50 or 60 
grains of chlorate of potassa into a paste with strong sul- 
phuric acid, putting it into a glass retort, and applying heat 
by means of warm water kept below 212°, when a gas of a 
bright yellowish green color is disengaged, which has an 
aromatic odor without the smell of chlorine, and is rapidly 
absorbed by water, to which it imparts its tint. This gas is 
the chlorous acid. 

What is tho rationale of this process? The sulphuric acid 
decomposes a part of the chlorate of potassa, and liberates 
chloric acid, which at the moment of separation resolves 
itself into chlorous acid, and oxygen; the last of which pas- 
ses over to the acid of the undecomposed chlorate of potas- 
sa, and is converted into perchloric acid. The resulting 
compounds are bisulphate, and perchlorate of potassa, and 
chlorous acid. 

What are the properties of chlorous acid? It unites with 
alkalies, and alkaline earths, forming salts soluble in water, 
and having bleaching properties. Phosphorus takes fire 
with an explosion when introduced into this gas. A tem- 
perature of 212° causes a violent explosion. 

How is chloric acid procured? To a. dilute solution of 
chlorate of baryta add weak sulphuric acid precisely suffi- 
cient for combining with the baryta; an insoluble sulphate 
9 



CHEMISTRY, 



of baryta !s formed, and precipitated; and pure chloric acid 
remains in the liquid. 

What are the properties of chloric acid? It reddens veg- 
etable blue colors, has a sour taste, and forms neutral salts 
with alkaline bases called chlorates. It has no bleaching 
properties, a circumstance which distinguishes it from chlo- 
rine, hypochlorous acids, and chlorous acids. It does not 
give a precipitate with a solution of the nitrate of silver. It 
may be concentrated by a gentle heat to an oily consistence. 
In this highly concentrated state it has a yellowish tint, an 
odor of nitric acid, sets fire to dry organic matter, and con= 
verts alcohol into acetic acid. 

It is easily decomposed by deoxidizing agents. 

It may be distinguished by forming a salt with potassa, 
which crystalizes in tables, has a pearly lustre, deflagrates 
like nitre, when thrown on burning charcoal, and yields 
chloric acid by the action of concentrated sulphuric acid. 

How is perchloric acid procured? By adding dilute sul- 
phuric acid to perchlorate of potassa, and applying heat to 
the mixture; white vapours arise that condense as a color- 
less liquid in the receiver which is a solution of perchloric 
acid. It may be obtained in a solid form by mixing it with 
strong sulphuric acid and distilling. It hisses when thrown 
into water, similar to red hot iron; forms a compound with 
potassa very slightly soluble in water, which is the perchlo- 
rate of potassa, and may be distinguished from the chlorate 
by not becoming yellowish on the application of hydro- 
chloric acid. The primary form of its chrystal is a right 
rhomb oidal prism. 

How is the quadro-chlorido of nitrogen procured? Dis- 
solve an ounce of hydrochlorate of ammonia in 12 or 10 
ounces of hot water; when it has cooled to 90o invert a 
wide mouthed glass bottle full of chlorine into it. The 
chlorine is absorbed, it acquires a yellow color, and in a few 
minutes globules of a yellow fluid float like oil upon its sur- 
face; when they acquire the size of a small pea they sink 
to the bottom of the liquid, and should be collected in a 
leaden saucer placed under the mouth of the bottle. 

What is the rationale of this process ? The ammonia is 
decomposed by the chlorine, hydrochloric acid is generated 
by the hydrogen of the ammonia uniting with a part of the 
chlorine, while the nitrogen of the ammonia unites with 
another pan of the chlorine. 



CHEMISTRY, 



91 



What are the properties of the quadro-ehloride of nitro 
gon? It is one of the most explosive compounds known," 
It is not congealed by a mixture of snow and salt, may bo 
distilled at 160°, explodes between 210° and 212°, contact 
with some combustibles causes detonation at common tem- 
peratures, particularly oils, both volatile, and fixed. Tho 
products of tho explosion are chlorine and nitrogen. This 
compound is 4 eq. of chlorine to 1 of nitrogen, or as stated 
by Berzelius 3 eq. chlorine to 1 of nitrogen. 

What are the compounds of chlorine with carbon'? The 
perchloride of carbon which consists of 2 eq. of carbon and 
3 of chlorine; the protochlorido of 1 eq. of chlorine, and 1 of 
carbon, and the dichloride of 2 eq. of carbon, and 1 of chlo- 
rine. 

How is porchloride of carbon procured? By exposing 
olefiant gas to chlorine; a combination takes place between 
them, and an oily liquid is generated, which is a compound 
of carbon, hydrogen, and chlorine. Put this into a vessel 
containing chlorine gas, and expose it to the direct rays of 
the sun ; the chlorine decomposes the liquid, hydrochloric 
acid is liberated, and tho carbon unites with the chlorine at 
the moment of separation. 

What are the properties of the perchloride of carbon? It 
is solid at common temperatures, has an aromatic odor, a 
nonconductor of electricity, and a powerful refractor of 
light; sp. gr, 2; fuses at 3.20°; it may be distilled without 
change, and assumes a crystalline form when it condenses. 

How is the proto-chloride of carbon procured? By pass- 
ing the vapor of porchloride through a red hot glas3 tubo 
filled with pieces of rock crystal it is partially decomposed; 
chlorine, and protochloride of carbon being the result. 

What are the properties of proto-chloride of carbon? It 
is a limpid colorless liquid, has a density of 1.55, does not 
congeal at 0°, and is converted into vapor at 160S or 170°. 
It may be distilled, but oxposure *to a red heat resolves it 
into its elements. 

What are the characteristics of the dichloride of carbon? 
It is of a white color, in the shape of small, soft, adhesive fi- 
bres, and has a peculiar odor resembling spermaceti. 

What are the compounds of chlorine and sulphur? The 
dichloride which contains 2 eq. of sulphur, and 1 of fchlo- 
rine; and tho proto-chloride which is 1 eq. of chlorine and 
1 of sulphur, 



90 



CHEMISTRY, 



What are the compounds of chlorine and phosphorus? 
The perchloride of phosphorus which is 5 eq. of chlorine 
and 2 of phosporus, and tho sosqui-chlorido of phosphorus, 
which is 3 eq. of chlorine, and 2 of phosphorus. 
$ How isgthe r perchloride of phosphorus procured. By in- 
flaming phosphorus in dry chlorine the perchloride collects 
inside of the vessel. It is white and very volatile. By 
heating it under pressure and cooling, it yields transparent 
prismatic crystals. 

..How is the sesqui chloride of phosphorus procured? By 
heating the perchloride with phosphorus; also bypassing 
the vapor of phosphorus over corrosive sublimate contained 
in a glass tube. 

What are the properties of the sesqu-ichloride of phos* 
phorus? It is a clear liquid, like water, of sp. gr. 1.46, 
emits acid fumes when exposed to the air owing to the de- 
composition of aqueous vapor. On mixing with water a 
mutual decomposition takes place, heat is evolved, and a 
solution of hydrochloric and phosphorous acids is obtained. 

How is chloro-carbonic acid or phosgene gas procured? 
By exposing equal parts by measure of chlorine, and car- 
bonic oxide gases to sunshine, a combination ensues, and a 
contraction to half the volume takes place. 

What are the properties of chloro-carbonic acid gas? It 
is colorless, has a strong odor, and reddens dry litmus paper, 
combines with gaseous ammonia, and forms a white solid 
salt, therefore has acid properties, Water decomposes it, 
and the result is hydrochloric and carbonic acids. 

What compound does chlorine form with boron? It 
forms the ter-chloride ; and it is procured by putting recent- 
ly prepared boron into chlorine, when it takes fire sponta- 
neously, and a colorless gas, the chloride of boron is formed, 
which is absorbable by water, and undergoes double de- 
composition at the same moment, the result of which is 
hydrochloric and boracic acids. 

What compound does chlorine form with silicon? The 
ter-chloride, which may be procured by heating silicon in a 
current of chlorine gas. The product is condensed into a 
colorless liquid, which by the addition of water is converted 
into hydrochloric and silicic acids. 

Is chlorine a simple or compound substance? It is gen- 
erally believed to be a simple body because it cannot bo 
decomposed by any known means. 



CHEMISTRY 



Iodine, 

Wkero is iodine found? It is found in many mineral 
springs in combination with sodium and potassium; it is 
also found in the water of the Mediterranean, in the oys- 
ter, and some other marine molluscous animals, in sponges, 
and in most kinds of sea-weed. It has also been found in 
the mineral kingdom in combination with silver. 

How is it procured? It is procured from kelp, an impure 
carbonate of soda, obtained by incinerating sea weeds. 
Carbonate of soda is prepared from the kelp; and tho 
residual liquor contains iodine in combination with potas- 
sium or sodium, which may be separated by the addition of 
sulphuric acid; by the application of heat the iodine is then 
sublimed, and may be collected in cool glass receivers. 

What are the properties of iodine? It is a soft, friable, 
solid, has a bluish color, metallic lustre, and crystalline ap- 
pearance, resembling micaceous iron ore. It is fused at 
225 ^ and ebullition takes place at 347°. If moisture is 
present it is sublimed rapidly at a temperature below boil- 
ing water. Its vapor is of a rich violet color, from which 
it derives its name. 

It is a non-conductor of electricity, and negatively elec- 
tric. It is very sparingly soluble in water, but very soluble 
in alcohol and ether. It has a strong affinity for the metals 
and most of the non-metalic combustibles, producing com 
pounds termed iodides. 

The test for iodino is starch: but tho iodine must be in a 
free condition, and tho solution cold. Its equivalent is 
126.3; symbol I; sp. gr. 3. 

What compound does iodine form with hydrogen? It 
forms the hydriodic acid which is 1 eq. of iodino to 1 cq. of 
hydrogen. 

How is hydriodic acid procured* It may be formed by 
the direct union of hydrogen with the vapor of iodine trans- 
mitted through a porcelain tube at a red heat. It may also 



be procured by the action of water on the periodide of 
phosphorus, which gives the phosphoric and hvdriodic acids, 
the latter of which passes over as a colorless gas. 

What are the properties of hydriodic acid gas? It has a 
sourjtaste, reddens vegetable blue colors, and produces white 
fumes when mixed with the air. 

Its salts are called hvdriodates. 



CHEMISTRY 



What are the compounds of iodine with oxygen? The 
oxide of iodine, iodons acid, iodic, and periodic acid. 

How is the oxide of iodine and iodous acid procured. 

By mixing the vapor of iodine and oxygen gas considera- 
bly heated, a yellow matter of the consistence of solid oil is 
produced, which is regarded as the oxide of iodine; and if 
the supply of oxygen be continued' it is converted into 
a yellow liquid which is the iodous acid. 

How is the iodic acid procured? By bringing iodine in 
contact with euchlorine, the chlorine unites with a portion 
of iodine, and the oxygen with another portion, and chlo- 
ride of iodine and iodic aeid is the result. 

They may be separated by applying heat; the chloride 
passes over and the acid remains. Or dissolve perchloide of 
iodine in water, and add a large quantity of strong sul- 
phuric acid, keep it cool, and iodic acid will be precipitated, 

What are the properties of iodic acid? It is a white, 
semi-transparent solid, has a strong astringent sour taste, 
inodorc-us, and is anhydrous. Its compounds are called 
iodates. 

Bromine. 

How is Bromine procured? From bittern, which contains 
hydrobromic acid, decomposable by chlorine, the chlorine 
unites with the hydrogen, and liberates the bromine into 
the liquid, which may be expelled by heat and condensed 
in a tube surrounded with ice. 

What are the properties of bromine? At common tem- 
peratures it is a blackish red liquid. Its odor is very disa- 
greeable, and resembles chlorine. It is congealed at 4° and 
is brittle. It emits, at common temperatures red colored va- 
pors, resembling nitrous acid, and boils at 116.5°. It resem- 
bles oxygen, chlorine and iodine, in being negatively electric, 
It is soluble in water, alcohol and ether, supports combus- 
tion under some circumstances, and is very destructive to 
life. It has not been decomposed, and is very analagous in 
its chemical relations to iodine and chlorine. It can gener- 
ally be detected by means of chlorine, which displaces bro- 
mine from its compounds. Its equivalent is 78.4; sp. gr. 2.9; 
symbol Br. 

What compound does bromine form with hydrogen? 
The hydrobromic acid, and may be produced by mixing the 
vapor of bromine with hydriodic acid, hydrosulphuric acid. 



CHEMISTRY. 



09 



or phosphuretted hydrogen gas, "when decomposition takes 
place, and hydrobromic acid is formed. 

What are the properties of hydrobromic acid? It is a 
colorless gas of an acid taste, and pungent odor, irritates 
the glottis, and when mixed with moist air yields white va- 
pors. It is decomposed by chlorine, hydrochloric acid gas 
is produced, and bromine is deposited. The salts of hydro- 
bromic acid are called hydrobromates. 

What compounds are formed with bromine and oxygen? 
The bromic acid is the only known compound. 

How is it procured? By decomposing a dilute solution of 
the bromate of baryta with sulphuric acid. The sulphate 
of baryta is precipitated, the bromic acid remains in solu- 
tion, and may be concentrated by slow evaporation, but 
cannot be entirely deprived of water without being decom- 
posed. 

What are the properties of bromic acid? It has an acid 
• taste, but not corrosive, very little odor, reddens litmus at 
first, and then destroys its color. It is analagous to iodic, 
chloric and nitric acids. Its composition is 1 eq. of bromine 
to 5 eq. of oxygen. 

How is the chloride of bromine procured? By passing a 
current of chlorine through bromine, and condensing the 
resulting vapors by a freezing mixture. 

What are the properties of chloride of bromine? It is a 
volatile fluid of a reddish yellow color, disagreeable taste, 
penetrating odor, and causes a discharge of tears from the 
eyes. Metals burn in its vapor, and chlorides, and bromides 
are formed. 

What other compounds does bromine form? It forms 
two compounds with iodine, two with phosphorus, one with 
carbon, and one with silicon. 

Fluorine. 

How is fluorine procured? By passing fluoride of boron 
over minium heated to redness, and collecting the gas in a 
dry vessel ; another mode is to mix fluoride of calcium and 
peroxide of manganese with sulphuric acid. 

What are the properties of fluorine? It is a yellowish 
brown gas, resembles chlorine in odor, bleaches, is nega§ 
tively electric, and has a powerful affinity for the metals 
and hydrogen. Its equivalent is 18=68; "specific gravity 
symbol F. 



100 



CHEMISTRY, 



What compound does fiuorino form with hydrogen? The 
hydrofluoric acid, which is 1 equivalent of fluorine to 1 of 
hydrogen. 

How is it procured 1 ? By adding concentrated sulphuric 
acid to fluor spar, (which is a fluoride of calcium,) reduced 
to a fine powder. The acid distils over on applying heat, 
and must be collected in a leaden receiver surrounded with 
ice. The result is hydrofluoric acid which comes over, and 
the sulphate of lime remaining in the retort. 

What are the properties of hydrofluoric acid? It is a 
colorless liquid at 32°; if exposed to the air it flies ofFin dense 
white fumes produced by its combination with the atmos- 
phere; has a powerful affinity for water, and a very pun- 
gent vapor. It is the most destructive to animal matter of 
all known substances, its application being followed by a 
malignant ulcer; it corrodes glass, and fluosilicic acid gas is 
produced. 

When diluted with three or four times it weight of wa- 
ter it is suitable for etching on glass. It has the properties 
of a powerful acid, reddens litmus, has a strong sour 
taste, neutralizes alkalies, forming salts called hydroflu- 
ates, or unites with metals forming compounds called flu- 
orides. 

How is fluoboric acid gas obtained? By heating a mix- 
ture of 12 parts of sulphuric acid, with 2 of fluor spar, and 1 
of vitrified boracic acid, in a flask. It may also be ob- 
tained by heating hydrofluoric, and boracic acids in a mo- 
talic retort. 

What are the properties of fluorboric acid gas? It is col- 
orless, has a penetrating pungent odor, reddens litmus, and 
forms salts with alkalies, called fluoborates. It has a very 
strong affinity for water, which it will take from any gas 
containing aqueous vapor, thus affording a delicate test for 
it in gases,. Water absorbs it, and forms a stong caustic so- 
lution. 

How is fluo-siiicic acid procured ? By mixing 2 parts 
of strong sulphuric acid, 1 of fluor spar, and 1 of sand, or 
pounded glass; on the application of heat it is disengaged, 
and may be collected over mercury. 

What are the properties of fluo-silicic acid ? It is a co- 
lorless gas, does not support combustion, destroys animal 
life, and unites with the watery vapor of the atmosphere, 
forming a white cloud. 



CHEMISTRY. 



101 



Ammonia. 

What is the composition of ammoniac al gas] It is a com- 
pound of nitrogen; one equivalent to three of hydrogen. 

How is it procured "? It may be procured from any salt 
of ammonia by the action of a pure alkali, or alkaline earth. 
Equal parts of the hydrochlorate of ammonia, and caustic 
lime are generally employed; heat is applied, the ammonia 
is given off, and the residue is chloride of calcium and lime, 
the lime being added in excess. A highly concentrated so- 
lution of ammonia is obtained by transmitting a current of 
the gas into water, as long as it will absorb it. To exhibit 
the gas pure, it must be'collected over mercury. 

What are the properties of ammonia? In a gaseous form 
it is colorless, powerfully pungent, irritates the eyes, and 
nose, irrespirable when pure, a non supporter of combustion, 
slightly combustible in oxygen gas, and a mixture with 
oxygen detonates by the electric spark, water being formed, 
and nitrogen set free. The gas may be liquified at a tem- 
perature of 50 °, and under a pressure of 6.5 atmospheros, 
forming a transparent colorless liquid. It is highly alkaline, 
forms salts decomposable by being heated with the fixed 
alkalies, or alkaline earths, or by a red heat. If combined 
with a volatile acid, the compound may be sublimed un- 
changed. It has a powerful affinity for water, which ab- 
sorbs 780 times its bulk, the sp. gr. of which, is diminished 
to 0.936. The liquid solution is clear, colorless, and posses- 
ses the peculiarities of the gas itself. 

How may free ammonia be detected? By the odor, its 
temporary action on turmeric paper, which it stains brown, 
and the color soon reappears owing to its volatility; and by 
its forming dense fumes when a glass rod moistened with 
hydrocloric acid, is brought near it ; these white fumes are 
the hydrochlorate of ammonia. 

Compounds of Hydrog-en and Cakbon. 

What are the known compounds of hydrogen and carbon ? 
Light carburetted hydrogen, olefiant gas, etherine, paraffine, 
eupione, rose oil stearine, wax oil, benzin, naphtha, oil of 
turpentine, citrine, camphine, oil of copaiva, juniper oil, 
lemon oil, savin tree oil, black pepper oil, naphthaline, para- 
naphthaline, and idrialiiie. 

What is the proper chemical name for light carburetted 
hydrogen? The dicarburet of hydrogen. Other names fre= 



102 



CHEMISTRY. 



quently used, are heavy inflammable air, the inflammable 
air of marshes, and hydrocarburet. 

Where is it found, and how is it obtained? It is formed 
in stagnant pools, from the decomposition of vegetable mat- 
ter, and may be procured by stirring the mud at the bottom, 
and collecting it in inverted vessels as it rises. Obtained 
in this way it contains a small quantity of carbonic acid gas. 

What are its properties'? It is colorless, tasteless, has very 
little smell, gaseous, a non supporter of combustion, or res- 
piration, inflammable, and burns with a yellow flame. With 
a sufficient portion of atmospheric air, or oxygen, it forms a 
detonating compound, water and carbonic acid being form- 
ed when it is detonated. 

The fire damp, so destructive in coal mines when ignited, 
is composed of this gas. 

Upon what principle is Sir Humphrey Davy's safety lamp 
constructed to prevent the explosion of this gas? It is found 
that the flame cannot pass through a narrow tube, however 
short, provided its diameter is sufficiently reduced. Now a 
piece of wire gauze may be regarded as an assemblage of 
these tubes, and flame will not penetrate it; therefore, if a 
common oil lamp is surrounded with a piece of this gauze, 
it will burn in the explosive mixture, without communicat- 
ing combustion to the gas externally. 

What is the composition of olofiant gas, and why is it so 
called? It is composed of 2 eq. of carbon, and 2 eq. of hy 
drogen, united to form 1 eq. of the gas; and is called defi- 
ant gas because it forms an oil-like liquid with chlorine. 

How is it procured? By heating a mixture of alcohol and 
sulphuric acid, in the proportion of one part of the former, 
to four of the latter; effervescence ensues, and olefiani gas 
passes over. 

What are the properties of olefiant gas? It is colorless, 
tasteless, and inodorous, a non supporter of combustion, and 
respiration, inflammable, burning with a dense white light, 
and forms an explosive mixture with oxygen, or atmosphe- 
ic air. It is decomposed by a succession of electric sparks, 
and by being transmitted through red hot porcelain tubes, 
A mixture of 2 parts chlorine, and 1 of olefiant gas, takes 
fire on the application of flame, the result of which, is hy- 
drochloric acid, and the deposition of charcoal ; but if they 
are allowed to remain at rest, they enter into direct combi- 
nation, and a yellowish oil is produced, 



CHEMISTRY. 



103 



Upon what does the flame of candles, lamps, gas lights, 
culinary fires, &c, depend ? The compounds of carbon, 
and hydrogen. 

How may they be procured for the purpose of gas lights? 

By the destructive distillation of bituminous coal, wood, 
oil, tar, or other inflammable substances. 

Upon what does the illuminating power of these com= 
pounds principally depend ? This power is in proportion to 
the quantity of carbon condensed into a volume, provided 
there is a sufficient supply of oxygen to consume it; other- 
wise tho excess of carbon renders the flame smoky. 
Hydrogen and Sulphur. 

What are the compounds formed by hydrogen and sul- 
phur? There arc two; hydrosulphuric acid, which is 1 eq. 
of hydrogen, and 1 eq. of sulphur; and the persulphuret of 
hydrogen, whioh is 1 eq. of hydrogen, and 2 eq. of sulphur. 

How is hydrosulphuric acid, or sulphuretted hydrogen as 
it is generally called, procured? By heating sesquisulphuret 
of antimony with four or five times its weight of hydrochlo- 
ric acid. 

What is the rationale of this process? The chlorine of 
the hydrochloric acid unites with the antimony of the ses- 
quisulphuret forming a sesquichloride, and the hydrogen of 
the hydrochloric acid unites with the sulphur of the sesqui- 
sulphuret, and forms hydro-sulphuric acid. 

What are the properties of hydrosulphuric acid? It is a 
colorless gas, reddens moist litmus, has a very offensive 
taste and odor, similar to putrid eggs, a non supporter of 
respiration, and combustion, combustible, water and sul- 
phuric acid being the products, and sulphur is deposited. It 
may be rcadHy distinguished by its odor, tarnishing silver, 
and tho character of its precipitate with solutions of arseni- 
ous acid, tartar emetic, or salts of lead. Its salts are called 
hydrosulphates. 

Hydrogen and Phosphorus. 

How is phosphuretted hydrogen procured? By the action 
of strong hydrochloric acid on phosphuret of calcium. 

What are its properties? It is a transparent, colorless 
gas of an offensive odor, and bitter taste, it is a non suppor- 
ter of combustion and animal life. It detonates with oxygen 
gen at the temperature of 300°, by the electric spark, and 
by diminished pressure. 



104 



CHEMISTRY. 



If the beak of a retort from which this gas issues is plung- 
ed under water so that bubbles of it may rise through the 
liquid, each one on reaching the surface will burst into a 
flame, and forma ring of dense white smoke, which enlarges 
as it ascends, presenting a beautiful appearance characteris- 
tic of this gas. 

Nitrogen and Cakbon. 

What compound is formed between nitrogen and carbon? 
Cyanogen or bicarburet of nitrogen. 

How is cyanogen procured? By heating bicyanide of 
mercury in a porcelain retort, and collecting the product 
over mercury. 

What are the properties of cyanogen? It is a colorless, 
transparent, irrespirable gas. It is limpid, liquid at the tem- 
perature of 45°, and under a pressure of 3.6 atmospheres. It 
will not support combustion, but burns with a beautiful 
flame. It is carbon 2 eq, and nitrogen 1 eq. It has a strong 
tendency to unite with elementary substances. 

What compound is formed by cyanogen, and hydrogen? 
Hydrocyanic, orprussic acid. 

In what does this acid exist in nature? In the leaves of 
laurel, and peach trees, and in the kernels of several fruits. 

How is it obtained, and what are its properties? By the 
action of hydrochloric acid upon bicyanide of mercury. It 
is colorless, liquid, has -an odor resembling peach leaves, 
very volatile, highly poisonous, and possesses slight acid 
properties. 

METALS. 

What are the characteristics of metals? They are con- 
ductors of electricity, and heat, electro-positive, opaque, ge- 
nerally good reflectors of light, and possess a peculiar lustre 
called metalic. 

What is the number of the metals? Forty-one. 

What metals possess the property of malleability ? Gold, 
silver, copper, tin, platinum, cadmium, lead, zinc, iron, nick- 
el, potassium, sodium, and frozen mercury. 

What are the metals which possess the property of duc- 
tility? Gold, silver, iron, and copper are the only ones capa- 
ble of being drawn into wires with facility. 

What is meant by the term calx? It is the product of 
the oxidation of a metal when heated in the air. 



CHEMIS TR Tj 



103 



What is meant by the reduction of a metal? It is the 
process by which metalic compounds are changed to their 
metalic state. 

What are the means used in reducing metals? Heat, the 
united agency of heat and combustible matter, the gal- 
vanic battery, and by the action of deoxidizing agents on 
their solutions. 

What are the oxides of metals called which are capable 
of uniting with acids and forming salts ? They are called 
alkaline or salifiable bases and are generally the protoxide. 

Have metals an affinity for chlorine ? They have a pow- 
erful affinity, and in many instances unite so as to present 
the phenomena of combustion; and will frequently displace 
oxygen from its union with the metals. 

What are the general characteristics of the metalic 
chlorides] Most of them are solid at common tempera 
tures, fusible by heat, and crystalize on cooling. Some of 
them may be sublimed without change, they are for the 
most part colorless, have no metalic lustre, and have the 
appearance of salts. 

Have the metals an affinity for iodine? They have a 
strong affinity, and most of these compounds are not de- 
composible by a red heat in close vessels. 

Have the metals an affinity for sulphur? They have a 
strong tendency to unite with it, and the union may be 
accomplished by heating tho metal with sulphur, by igfhi- 
ting a mixture of a metallic oxide and sulphur, and. by- 
several other processes. 

How are the metals divided? Into two classes. 

Class 1st. Those which yield alkalies and earths by oxi- 
dation. Class 2nd. Those the oxide3 of which are neither 
alkalies or earths. 

The 1st class comprises twelve metals which have been 
arranged into three orders. 

Order 1st. The metalic bases of tho alkalies. They arc 
potassium, sodium and lithium. 

Order 2nd. Tho metalic bases of the alkaline earths. — 
These are barium, strontium, calcium and magnesium. 

Order 3d. The metalic bases of the earths. They are 
aluminum, siucinum, yttrium, thorinum and zirconium. 

The 2nd class comprises twenty-nine metals, and may be 
arranged into three orders. 

Order 1st. The metals which decompose water at a red 
10 



too 



CHEMISTRY, 



heat. They are manganese, iron, zinc, cadmium, tin, co- 
balt and nickel. 

Order 2nd. The metals which do not decompose water at 
any temperature, and the oxides of which are not reducible 
to a metalic state by heat alone. They are arsenic, chro- 
mium, vanadium, molybdenum, tungsten, columbium, anti- 
mony, uranium, cerium, bismuth, titanium, tellurium, cop- 
per, and lead. 

Order 2d. The metals the oxides of which are reduced to 
the metalic state by a red heat. They are mercury, silver, 
gold, platinum, palladium, rhodium, osmium, and iridium, 

Potassium. 

How is potassium procured? It may be procured by 
subjecting moistened hydrate of potassa to a galvanic bat- 
tery, and the potassium will be found at the negative pole. 
A more abundant supply may be obtained by bringing 
fused hydrate of potassa in contact with turnings of iron 
heated to whiteness in a gun barrel. Another method is to 
mix iron filings and charcoal with potassa, in an iron bottle ; 
in both cases the potassium is sublimed, and may be col- 
lected. The rationale is that the iron and charcoal abstract 
oxygen from the potassa, and the potassium is liberated. 

What are the properties of potassium? It is solid at 
common temperatures, perfectly fluid at 150°, soft and mal- 
leable at 50°, and brittle at 32°; undergoes sublimation at 
a low red heat without change, provided there is no oxygen 
present, and is similar in lustre to mercury. Its prominent 
chemical property is its affinity for oxygen, which it com- 
bines with rapidly in the air, and by contact with ice or fluids 
containing oxygen, so that to preserve it it must be kept in 
tubes hermetically sealed, or under the surface of liquids 
which contain no oxygen, such as naphtha, oil copaiba, &c. 
Its equivalent is 39.15; specific gravity 0.86; symbol Po, 
or K. 

What are the compounds of potassium and oxygen ? They 
are the protoxide, which consists of 1 equivalent of potassium 
and 1 equivalent of oxygen ; and the teroxide which is 1 
equivalent of potassium, and 3 equivalents of oxygen. 

What are the properties of the protoxide of potassium, 
potash, or potassa? Anhydrous potassa is a white solid, 
highly caustic, fuses at a temperature a little above redness, 
and is not decomposed or volatalizod by a very high heat. 



CHEMISTRY, 



107 



It has a great affinity for water, and forms three com- 
pounds with it with the disengagement of heat during 
the combination. It may be further distinguished by ad- 
ding tartaric acid in excess to a salt of potassa dissolved in 
cold water, and a white o precipitate, the bi-tartrate of pot- 
assa is formed. It may also be precipitated by perchloric 
acid, the perchlorate being nearly insoluble ; and a solution 
of the chloride of platinum produces a yellow precipitate. 
There is also a light gelatinous precipitate by silicated hydro- 
fluoric acid. 

How is the teroxide of potassium formed? By burning 
potassium in the open air, or in oxygen gas an orange col- 
ored substance is formed, which is the teroxide of po- 
tassium. 

How is the iodide of potassium procured? It may be 
formed by heating potassium in contact with iodine; the 
union ot which takes place with the evolution of light and 
heat. But for procuring it in quantity the preferable mode 
is to add iodine to a hot solution of pure potassa, until the 
alkali is neutralized; by this process iodide of potassium 
and iodate of potassa are generated; evaporate this to dry- 
ness, and expose in a platinum crucible to a red heat, which 
will decompose the iodate, leaving the iodide of potassium. 

What are the properties of the^iodide of potassium? It 
is easily fusible, rises in vapor at a heat below redness, very 
soluble in water and alcohol, and deliquescent in a moist 
atmosphere. 

Sodium. 

How is sodium procured? By the same processes that 
we obtain potrssium, substituting soda for the potassa. 

What are the properties of sodium? It has a strong me- 
talic lustre, in color similar to silver, is soft at common 
temperatures, fuses at 200°, and is vaporized at a red heat. 
It is oxidized by water like potassium. Its equivalent is 
23.3; specific gravity 0.972; symbol So or Na. 

What are the compounds of sodium and oxygen? They 
are the protoxide, which is 1 eq. of sodium, and 1 eq. of 
oxygen; and sesquioxide which is 2 equivalents of sodium 
and 3 of oxygen. 

How is the proto L e of .odium, or sovla obtained, and 
what are its propcrt'- ? It rray be obtaissd by the c Ida- 
tion of sodium in air or water, from the ashes of sea weeds, 



CHEMISTRY 



or common salt. Anhydrous it is a grey solid, difficult of 
fusion, and very similar to potassa in both its sensible and 
chemical properties, but may be distinguished from it by its 
farming with sulphuric acid a salt easily recognized as 
Glauber's salt, or sulphate of soda. Its salts are all soluble 
in water, cannot bo precipitated, and on exposing them by 
means of a platinum wire to the blew pipe a rich yellow 
color is imparted to the flame. 

How the sesqui oxide of sodium obtained? By heating 
sodium to redness in oxygen gas. It is of an orange color, 
with neither acid or alkaline properties, and is decomposed 
by water into soda and oxygen. 

How is the chloride of sodium procured' 1 It may be 
formed by burning sodium in chlorine, by heating sodium 
in hydrochloric acid, and also by neutralizing soda with 
hydrochloric acid. It is found in nature under the name of 
rock salt, and in sea water, of which i* forms a large- part, 
also in many saline springs 

What are the properties of the chloride of sodium? It 
has an agreeably salino taste, fuses at a red heat, forms a 
transparent brittle mass on cooling, deliquesces in a moist 
atmosphere, but not in a dry one, and is decomposed by 
sulphuric acid, hydrochloric acid being set at liberty, and 
sulphate of soda formed It possesses the property in a very 
high degree of preserving meat from putrefaction, and is 
used extensively in the arts. 

Lithium. 

How is lithium procured? By decomposing lithia by 
means of galvanism. It is a white colored metal, resem- 
bling sodium, and its eq. according to Berzelius is 6.44; 
symbol L, 

What compound does lithium form with oxygen? It 
forms but one compound, which is 1 eq. of each, and is 
called lithia. 

What are the properties of lithia? It closely resembles 
soda and potassa in its chemical relations. Its salts when 
heated on a platina wire before a blow pipe tinges the flame 
of a red color. 

Barium. 

How is barium procured ? By decomposing the carbonate 
of baryta by means of galvanism, and forming an amalgam 
with mercury, which amalgam may be decomposed by 



CHEMISTRY. 



109 



heat in a vessel free from air. The mercury being volatal- 
ized leaving the barium in its purity. 

What are the properties of barium? It is a dark grey 
colored metal, attracts oxygen from the air, and yields a 
white powder, which is baryta, and decomposes water, hy- 
drogen escaping, and baryta is formed. Its eq. is 68.7 ; 
symbol Ba. 

. - What are the compounds of barium and oxygen? There 
are two; the protoxide which is 1 eq. of barium, and 1 eq. 
of oxygen; and the peroxide which is 1 eq. of barium and 
2 eq. of oxygen. 

How is the protoxide of barium, barytes or baryta pre- 
pared? It is produced by the oxidation of barium in air or 
water, and may be prepared by decomposing the nitrate of 
baryta at a red heat, or by subjecting the carbonate to an 
intense white heat with charcoal. 

What are the properties of protoxide of barium ? .It is a 
grey powder, sp, gr. 4., difficult to fuse, has caustic alkaline 
properties, converts vegetable blues to green, and neutral- 
izes acids, has a strong affinity for water, and an intense 
heat is produced by the union. It is distinguished by its 
alkaline solution, by all its soluble salts forming white pre- 
cipitates, the carbonate of baryta, by the addition of alka- 
line carbonates; and the sulphate of baryta by the addi- 
tion of a soluble sulphate or sulphuric acid; and by the 
characteristics of chloride of barium, formed by the action 
of the hydrochloric acid on baryta. Tho carbonate of 
baryta is soluble in dilute acid, and is poisonous in a solu- 
ble state, whether the solution is formed from acid in the 
stomach or out of it. 

How is the peroxide of barium procured? By passing 
dry oxygen gas over pure baryta at a low red heat. This 
oxide is used in forming the peroxide of hydrogen. 

^TEOXTIUItf. 



How is strontium obtained? By a process analagous to 
that employed in procuring barium. 

What are the properties of strontium? It is a heavy 
metal similar in properties to barium. Its equivalent is 
43.8; symbol Sr. 

What are the oxides of strontium? They are the pro- 
toxide, which is 1 eq. of strontium and 1 eq. of oxygen; 

10* 



no 



CHEMISTRY. 



and the peroxide which is 1 oq. of strontium and & cq. of 
oxygen. 

How is the protoxide of strontium or strontia prepared? 
From the nitrato and carbonate of strontia, in the same 
manner as baryta* which it resembles in most particulars, 
its salts are not poisonous; when heated on a platinum wire 
before a blow pipe it communicates a red tint to the flame. 

How is the peroxide procured? In the same way as per- 
oxide of barium,, and it is possessed of similar properties. 

Calcium. 

How is calcium procured? Its existence may be shown 
in the same manner as barium. It is of a whiter color than 
either barium, or strontium, and union with oxygen converts 
it into lime. Its equivalent is 20.5, symbol Ca* 

How many compounds are there of calcium,' and^oxygen? 
Two; the protoxide, which is 1 eq., of calcium, and 1 eq. of 
of oxygen; and the peroxide, which is 1 eq. of calcium, and 
2 eq. of oxygen. 

How is the protoxide of calcium, lime, or quicklime, pro- 
cured? By subjecting carbonate of lime to heat, sufficient- 
ly strong to expel its carbonic acid. 

What are its properties? It is a brittle, white, earthy sub- 
stance, somewhat alkaline, phosphoreseent^when heated to 
redness, fusible with great difficulty, has a strong affinity 
for water, which produces an increase of temperature by the 
union, and the result is slacked lime; it parts with its water 
at a red heat. 

The most delicato test for its presence is oxalate of ammo- 
nia or potassa, the oxalate being insoluble. The nitrate 
yields prismatic crystals, is very deliquescent and soluble in 
alcohol, which properties distinguish it from baryta, and 
strontia, the nitrates of which er} r stalize in octohedrons, 
and are not deliquescent, or soluble in alcohol. 

How is the peroxide of calcium procured? In the same 
way as the peroxide of barium, and possesses similar prop- 
erties. 

Magnesium, 

How is magnesium procured? By the action of galvan- 
ism. It may also bo obtained by the action of potassium on 
the chloride of magnesium, 



CHEMISTRY. 



in 



What are its properties'? It has a brilliant metalic lustre, 
a white color, is very malleable, and fuses at a red heat. It 
burns in oxygen gas when heated to redness, and magnesia 
is formed. Its equivalent is 12.7, symbol Mg. 

What compound does magnesium form with oxygen? 
The protoxide, known as magnesia, which is 1 eq. of mag^ 
neslum, and 1 eq of oxygen. It may be procured by expos- 
ing the carbonate of magnesia to a high red heat. 

What are the properties of magnesia] It has feeble al- 
kaline properties, exeept in forming neutral salts with acidsv 
Its sulphate is very soluble, which serves to distinguish it 
from the other alkaline earths. It is precipitated from its- 
salts as a hydrate by pure alkalies, and may be distinguish- 
ed and separated from lime by the oxalate of ammonia. 

Alu3iixu:>i. 

How is aluminum procured ? By the decomposition of the 
chloride of aluminum by potassium. 

What are the properties of aluminum? It is a grey pow- 
der, resembling platinum, or in small scales, or spangles of 
a metalic lustre; a conductor of electricity when fused, but 
not in powder, and fusible at a temperature above the fusing 
point of cast iron. Burns in the open air when heated to 
redness, and forms a white aluminous earth. Its equivalent 
is 13.7, Symbol Al. 

What is the composition of alumina or aluminous earth? 
It is a sesquioxide of aluminum. 

How is alumina procured ? By dissolving purified alum, 
adding an excess of carbonate of potassa, the alumina is 
precipitated, and may be collected on a filter. 

What are the properties of alumina ? It is tasteless, ino- 
dorous, insoluble in water, very infusible, and has a power- 
ful affinity for water. 

It may be distinguished by being separated from the acids 
as a hydrate, by the alkaline carbonates, and ammonia; by 
being precipitated by pure soda, or potassa, and the precipi- 
tate redissolved by an excess of the alkali. 

Manganese or Maxgaxesium. 

How is manganese procured ? It is procured from the ox- 
ide, by heating it in contact with oil, and charcoal. 

What are the properties of manganese? It is of a grey- 
ish white color, gmuular texture, difficult of fusion, tarnish- 



us 



CHEMISTRY. 



es by exposure to the air, and burns if heated" to redness in 
open vessels. Its eqivalent is 27.7; symbol Mn; specific 
gravity 8. 

What are the compounds of manganese, and oxygen? 
The protoxide, 1 eq. of each; the sesquioxide. 2 eq/of man- 
ganese, and 3 eq. of oxygen; the red oxide, 3 eq. of manga- 
nese, and 4 eq. of oxygen ; varvacite, which is 4 eq. of man- 
ganese, and 7 eq. of oxygen; manganic acid, 1 eq. of man- 
ganese, and 3 eq. of oxygen; and permanganic^acid, which 
is 2 eq of manganese, and 7 eq. oi oxygen. 

How is the protoxide of manganese procured? By expos- 
ing the peroxide, sesquioxide, or red oxide of manganese to 
charcoal, and heat combined, or to heat, and a current of 
hydrogen. 

What are the properties of the protoxide of manganese? 
It is of a light green color, attracts oxygen from the air, and 
unites readily .with acids. 

How is the sesquioxide ol manganese procured? It is 
found in nature, and may be termed by exposing the perox- 
ide for some time to a moderate led heat. 

How is the peroxide or black o tide of manganese procu- 
red? It is found in natui 3 mixe d with silicious, or alumin- 
ous earths, oxide of iron, unci catbonate of lime. It may also 
be formed artificially, by subjecting the nitrate of the pro- 
toxide of manganese to a 1 )w red heat, until the nitric acid 
is expelled. 

What are its properties? It i i unchangeable by exposure 
to the air, insoluble in wat ;r, does not unite with acids, or 
alkalies, and yields oxygen gas when boiled with sulphuric 
acid; or if hydrochloric acid is ased, chlorine is evolved. 

It is much used in the arts, for manufacturing glass, and 
in preparing chlorine for baching pm poses. 

How is the red oxide procaied? Ii is found in nature, 
and may be artificially formed by exposing the peroxide, or 
sesquioxide to a white heat. Of the same degree of fine- 
ness it is brownish-red when cold, and black when warm. 

How is the varvacite procured? It is only procured as a 
natural production among some of the ores of manganese. 

Iiic N. 

How is iron generally found in nature? In large quanti- 
ties in combination with oxygen and sulphur, called ores of 



CHEMISTRY. 



113 



iron; but it is diffused almost universally in greater or smal- 
ler quantities. 

How is iron procured? By subjecting the ores roasted, 
and reduced to coarse powder, to the action of charcoal, or 
coke and lime at a high heat. 

What is the rationale of this process ? The carbon de- 
prives the oro of its oxygen, and the lime acts as a flux by 
combining with the impurities and forms a compound fusi- 
ble mass, called slag, which allows the melted particles of 
iron to descend through it, and collect at the bottom. 

"What are the properties of iron ? It has a grey color, 
strong metalic lustre, susceptible of polish, is ductile, mal- 
leable, and very tenacious. It is attracted by the magnet, 
and may be rendered magnetic, a property possessed by no 
other metal except nickel. It has a strong affinity for oxy- 
gen, but docs not take it from a dry atmosphere, but if mois- 
ture be present it oxidizes, or rusts; if heated to redness in 
the open air it absorbs oxygen rapidly, and is converted into 
black scale-, which are the black oxide of iron; and if in 
oxygen it is attended with vivid scintillations. Its equiva- 
lent's 28, svmbol Fe, sp. err. < .788. 

What are the compounds of iron and oxygen? The pro^ 
toxide, which is 1 eq. of each; the sesquioxide, which is 
2 eq. of iron, and 3 eq. of oxygen; and the black oxide, 1 eq. 
of the protoxide, and 1 eq. of the sesquioxide combined. 

Where is the protoxide of iron found, and what are its pro- 
perties? It is the base of the native carbonate of iron. It 
is formed when metalic iron is placed in dilute sulphuric 
acid; and is precipitated as a white hydrate, from its salts 
by pure alkalies. Its salts when in solution absorb oxygen 
from the air. A solution of galls does not produce a change 
of color, but alkaline hydro-sulphates cause a black precipi- 
tate, the proto-sulphuret of iron. 

How is the red or sesquioxide of iron procured? It is a 
natural product, known as red haematite, and is found mas- 
sive, fibrous, and in rhomboidal crystals. It may be formed 
by dissolving iron in nitro-hydrochloric acid, and precipitat- 
ing with an alkali. In this state it is a hydrate. 

What are the properties of the red or sesquioxide? It 
combines with most of the acids, forming salts, which are 
generally red; and it may be precipitated from them by 
pure alkalies as a hydrate. Prussian blue is formed by the 
addition of ferrocyanuret of potassium to this oxide, and a 



114 



CHEMISTRY. 



blood red color is produced by sulphocyanuret of potassium, 
and a black color by the infusion of galls. These last re- 
agents may be considered as unerring tests for the minutest 
quantity of the sesquioxide, and any other oxide may be 
converted into this by nitric acid. It is not attracted by the 
magnet. 

Where is the black or magnetic oxide of iron found, and 
what is its composition'? It is found native, often crystaliz- 
ed in regular octohedron and dodecahedron form; it is at- 
tracted by the magnet, and may become magnetic. It is 
also formed when iron is heated to redness in the open air, 
or in contact with aqueous vapor. It is composed of the 
protoxide, and the red or sesquioxide combined. 

What are the compounds of sulphur, and iron? The te- 
trasulphuret, disulphuret, proto-sulphuret, sesquisulphuret, 
bisulphuret, and magnetic pyrites, which is a compound of 
bisulphuret and protosulphuret. 

What are the compounds of carbon and iron? There are 
three distinct compounds; graphite, cast or pig iron, and 
steel. 

Whore is graphite (called also plumbago and black lead) 
obtained? It is found as a natural production, and maybe 
formed artificially by exposing iron with an excess of char- 
coal to a violent and long continued heat. It contains about 
5 per cent of iron when pure. 

Zinc. 

How is zinc found in nature, and how is it procured? It 
is found native as a carbonate called calamine, and as a 
sulphuret, called zinc blende. It is procured by exposure 
to heat and carbon from the calamine, and from the blende 
by the same process after roasting or exposure to air at a 
low red heat. The metal is distilled by a process termed 
distillation by descent, and may bo purified by being again 
distilled. 

What are the properties of zinc? It has a metalic lus- 
tre, bluish white color, a laminated texture, is hard and 
brittle, and by exposure in close vessels to a white heat it is 
sublimed unchanged. It absorbs oxygen, and forms the 
white oxide or flowers of zinc, if heated to fusion in open 
vessels, or if heated to redness in a closed vessel, and the 
cover removed combustion takes place with a white light. 
Its equivalent is 32.3; sp, gr. 7; symbol Zn. 



CHEMISTRY. 



115 



What are the compounds of zinc and oxygon ? There 
are two, the protoxide which is 1 cq of each, and the perox- 
ide the composition of which is uncertain. 

How is the protoxide of zinc procured?- By the addition 
of dilute sulphuric acid to zinc, and by collecting the 
flakes which arise during the combustion of zinc. 

What are tho properties of the protoxide of zinc? It is 
soluble in water, forms regular salts with acids, and com- 
bines with some of the alkalies. It is precipitated from its 
solutions as a white hydrate by pure potassa or ammonia; 
as a carbonate, by the carbonate of ammonia; and is redis- 
solved by tho addition of an excess of the precipitant. Al- 
kaline carbonates precipitate it as a white carbonate, and 
hydrosulphate of ammonia precipitates it as a hydratcd sul- 
phuret. 

Tin. 

How is tin generally found in nature and how is it pro- 
cured? It occurs native as an oxide; from which it may 
be procured by heat and charcoal. 

What are the properties of tin? It resembles silver in its 
appearance; its brilliancy is lost slowly by contact with the 
atmosphere, it is malleable, inferior in ductility and tenacity, 
soft, inelastic, and when bent backwards and forwards pro- 
duces a peculiar crackling noise. Its equivalent is 58.9; 
sp. gr. 7.291 ; symbol Sn. 

What are the compounds of tin and oxygen? The pro- 
toxide 1 eq. of each; scsquioxide 2 eq. of tin and 3 eq. of 
oxygen, and the binoxide 1 eq., tin and 2 eq. of oxygen. 

What is the purple of Cassius ? It is a combination of 
the binoxide of tin and protoxide of gold, produced by the 
action of the protoxide of tin on a solution of gold. This 
property of forming a purple precipitate with a solution of 
gold is considered as a test for tho protoxide of tin. 

What is understood by stannates ? They are combina- 
tions of binoxide of tin which possesses feeble acid proper- 
ties, with the alkalies. 

What is the composition of the fuming liquor of Libavius? 
It is the bichloride of tin, and the dense white fumes 
emitted when it is exposed to the air are caused by its union 
with moisture. 

Cobalt. 

How is cobalt found in nature? It is generally found in 



J 16 



CHEMISTRY 



combination with arsenic. Its equivalent is 29.5; sp. gr. 
7.834; symbol Co. 

What are the compounds of oxygon and cobalt? The 
protoxide, which is 1 eq. of each; the 4-3 oxide, 3 eq. of co- 
balt and 4 eq. of oxygen; j.ho sesquioxide 2 eq. of co- 
bait and 3 eq. of oxygen. 

Nickel. 

How is nickel found in nature? Generally as a copper 
colored mineral, which is the arsenuret of nickel, contain 
ing small portions of sulphur, copper, cobalt and iron. Tk® 
process for procuring it is somewhat complicated. 

What are the properties of nickel? It is whitish, inter- 
mediate between tin and silver, has a strong motalic lustre, 
and is ductile and malleable. It is attracted by the mag- 
net, and may be rendered magnetic, but its oxides are not. 
Its eq. is 29. 5; sp. gr. 8.279; symbol Ni. 

Arsenic 

How is arsenic found in nature? Sometimes native, but 
generally in combination with other metals. 

How is it procured? By roasting the ores it is volatalizcd, 
combines with oxygen, and is condensed in cakes, which 
are the white oxide. From this the metal may bo procured by 
heat and charcoal, the pure metal being sublimed, and may 
be collected in a proper vessel. 

What are the properties of arsenic? It is brittle, has a 
motalic lustre, a whitish grey color, and crystalline. Its sp. 
gr. is 5.8843; eq. 37.7 ; symbol As. 

What arc the compound of arsenic and oxygen? There 
arc two; the arsenious acid which is 2 eq. of arsenic and 3 
eq. of oxygen; and the arsenic acid, 2 eq. of arsenic and 5 
eq. of oxygen. 

How is arsenious acid prepared? It is generated when 
arsenic is heated in open vessels, audit may be prepared by 
digesting it with dilute nitric acid, or the white arsenic of 
commerce (generated by roasting the ores of arsenic and 
cobalt,) may" be purified by a second sublimation, 

What are the properties of arsenious acid? It is mostly 
sold in the state of fine white powder, but when first sub- 
limed it is in brittle masses of a vitreous lustre. It is sub= 
limed at 380 Q , tmd may be condensed on cold surfaces. It 
is susceptible of two different crystalline forms, and is 



CHEMISTRY. 



117 



therefore termed dimorphous. It reddens vegetable blue 
colors feeblv, combines with salifiable bases, forming salts 
termed arsenates, and is a virulent poison. 

What are the important tests for arsenious acid? The 
ammoniacal nitrate of silver, ammoniacal sulphate of copper, 
hydro-sulphuric acid, and hydrogen gas. 

" The first of these produces a yellow precipitate, the arsen- 
ite of oxide of silver. This test is liable to some objection 
when sea salt or animal and vegetable infusions are present, 
from the arsenices of siver not subsiding at all, or in such an 
impure state that it cannot be recognized properly. 

The second, the ammoniacal sulphate of copper produces 
a green precipitate, known as Scheele's green ; yet there are 
circumstances under which a greenish precipitate may be 
formed with ammoniacal sulphate of copper, that may bo 
mistaken for Scheele's green where no arsenic is present, 
and under other circumstances it may be present in minute 
quantity, and no precipitate be formed. It may therefore, 
be considered a fallacious test When applied to mixed fluids, 
however sure it may be when the arsenious acid is dissolved 
in pure water. 

The third, the hy drosulph uric acid produces a yellow ish 
color in the liquid when this gas is passed through it, from 
the formation of orpiment, or the scsquisulphuret of arse- 
nic. When this test is used the liquid should not contain a 
free alkali, and to avoid it a little acetic acid should be added. 

Thus far this test may be considered fallacious, as the 
same colored precipitate may be produced with selenium, 
cadmium, tin, and antimony. But the precipitate, the scs- 
quisulphuret of arsenic formed by this process, may be dis- 
tinguished from all other substances by being dried, mixed 
with black flux, and heated in a glass tube to redness; do- 
composition takes place, and the mstalic arsenic is deposit- 
ed of an iron grey color externally, and crystalline internal- 
ly, on the cool part of the tube. Additional evidence may 
be had by converting the metal into arsenious acid, which 
may be done by holding that part of the tube in which the 
metal is deposited, over a spirit lamp in such a manner that 
the metal may be sublimed slowly, and as it is vaporized it 
combines with oxygen, and is deposited in another portion 
of the tube in beautiful octohedral crystals, that may easily 
be detected by a practiced eye. In this experiment the tube 
should be clean and drv, 
11 



118 



CHEMISTRY. 



The fourth, the application of hydrogen. An arsennret- 
ted hydrogen is formed, which is a gaseous compound that 
yields metalic arsenic or arsenious acid, and water in com- 
bustion; the metalic arsenic or arsenious acid being deposi- 
ted, according as the supply of oxygen is more or less abun- 
dant, each with their peculiarities. 

For the mode of conducting this process see Turner's, or 
some recent work on chemistry. 

What are the compounds of sulphur and arsenic'? There 
are three. The proto-sulphuret, or realgar is found in the 
mineral kingdom, and may be formed artificially by heating 
arsenious acid with about half its weight of sulphur until it 
fuses. Its eq. is 53.8. 

The sesquisulphuret or orpiment is also found in nature, 
and may be prepared by fusing together equal parts of arse- 
nious acid and sulphur. This is the coloring principle of the 
paint called King's yellow. 

The persulphuret, which may be prepared by passing 
hydrosulphuric acid gas through a solution of arsenic acid. 
It resembles orpiment in color. 

Antimony. 

How is antimony found in nature? It is generally found 
as a sulphuret, and called crude antimony; although it some- 
times occurs native. 

How is it procured? By heating the sulphuret in a cover- 
ed crucible with half its weight of iron filings, or by mix- 
ing with it two thirds its weight of cream of tartar, and one 
third nitre ; and throwing the mixture in small portions suc- 
cessively into a red hot crucible. 

What are the properties of antimony? It is brittle, white, 
running into bluish grey, has considerable metalic lustre, 
fuses at 810°, and is volatilized at a very high temperature. 
Its eq. is 64.6; sp. gr. 6.702; symb. Sb. 

What are the compounds of antimony, and oxygen? 
The sesquioxide, which is 2 eq. of antimony, and 3 eq. of 
oxygen: the antimonious acid, 2 eq. of antimony, and 4 eq. 
of oxygen; and the antimonic acid, 2 eq. antimony, and 
5 eq. oxygen. 

How is the sesquioxide of antimony procured? By subli- 
mation during the combustion of antimony; and by adding 
carbonate of potassa, or soda to a solution of tartar emetic. 

What are the properties of the sesquioxide of antimony? 



CHEMISTRY- 119 

Tt is a white powder of a somewhat dirty appearance, when 
heated it acquires a yellow tint, and if protected from the 
atmosphere it may be sublimed without change. Heated in 
contact with the air. it absorbs oxygen, and if heated sud- 
denly, it takes fire and burns; in both cases antimonioug 
acid is generated. It is the only combination of oxygen and 
antimony which form salts with acids, and is the base of 
tartar emetic, or the tartrate of antimony and potassa. Its 
salts are insoluble in, or decomposed by water, except tartar 
emetic. The insoluble salts of antimony are rendered solu- 
ble by excess of tartaric, or hydrochloric acids. The pres- 
ence of antimony in solution may easily be detected by hy- 
drosulphuric acid, which produces an orange colored precipi« 
tate, hydrated sesquisulphuret of antimony, called Kerme's 
mineral. 

What are the combinations of chlorine, and antimony? 
They are sesqui chloride or butter of antimony, the bichlo- 
ride, and the perchloride. 

What are compounds of sulphur and antimony? They 
are the sesquisulphuret, the bisulphuret, and the porsui- 
phuret. 

Copper. 

How is copper found in nature? It is often found 
native, but generally in combination with sulphur, as the 
native sulphuret, which is sometimes combined with sul- 
phuret of iron. 

What are the properties of copper? It is of a red color, 
which distinguishes it from all other metals, except titani- 
um, ductile, malleable, tenacious, hard, elastic, and sonor- 
ous. It does not change in a dry atmosphere, but rusts in 
a damp one, and is converted into a green carbonate of the 
black oxide of copper. Its equivalent is 31.6; sp, gr. 8. 895. 
symbol Cu, 

What are the compounds of copper and oxygen? They 
are the red or dioxide, which is 2 eq. of copper, and 1 eq, of 
oxygen; the black or protoxide, 1 eq. of copper, and 1 eq.of 
oxygen; the superoxide, 1 eq. of copper, and 2 eq. of oxy- 
gen. 

Which of these oxides unites with acids and form salts! 
The protoxide. 

What is blue vitriol ? It is the sulphate of copper, form* 
ed by boiling sulphuric acid upon copper. 



CHEMISTRY. 



How are the salts of copper distinguished? Thev have a 
green or blue tint, hydrosulphuric acid precipitates' a dark 
brown sulphuret; and ferrocyanuret of potassium precipi- 
tates a reddish brown ferrrocyanuret ; and it is precipitated 
in the metalic state by a rod of iron, or zinc. 

What is crude verdigris] It is a mixture of neutral ace- 
tate or sub-acetate of copper with impurities. 

What are the crystals of Venus? It is a crystalized neu- 
tral acetate. 

Lead. 

How is lead found in nature? As a sulphuret, the gale- 
na of mineralogists; as an oxide; and as a salt. 

How is it procured ? From the galena, by heating it in a 
reverberatory furnace, which oxidizes a portion of the lead, 
and drives off the sulphur, yielding the protoxide of lead, 
and the pure metal; and it may be obtained from any of its 
oxides by heat, and charcoal. 

What are the properties of lead? It has a bluish grey 
color, a strong metalic lustre, tarnishes by exposure to the 
air, and acquires a thin coat of the carbonate of the protox- 
ide. It fuses at 612°, and is ductile in large masses. Its- 
equivalent is 103.6; sp. gr. 11.352; symbol Pb. 

What are the compounds of lead, and oxygen? They are 
the dinoxide, which is 2 eq. of lead, and 1 eq. of oxygen; 
th e protoxide or massicot, 1 eq. of lead, and 1 eq, of oxygen ; 
the peroxide, 1 eq. of lead, and 2 eq. of oxygen ; and the red 
oxide or minium, 3 eq. of lead, and 4 eq of oxygen. 

What are the characteristics of the dinoxide? It is gen- 
erally known as dross; it is of a dark grey color, and is un- 
important in its chemical relations. 

How is the protoxide procured? By collecting the grey 
film which forms on the surface of melted lead, and expos- 
ing it to heat and air until it becomes yellow. 

In the state of powder it is called massicot; but when 
partially fused-, by which it is vitrified, it is called litharge* 
and contains a slight mixture of red oxide. 

What are its properties ? It has a lemon yellow color, it 
is insoluble in w T ater, fused at a bright red heat, and un- 
changeable in the fire, but may be reduced by heat, and 
combustible matters- It is the base of all the salts of lead., 
and they are generally of a white color, It acts in some 
cases as an acid by uniting with alkalies. 



CHEMISTRY. 



131 



Which salt of lead is the most poisonous? The carbo- 
nate or white lead, so that any salt of lead, as the acetate, 
which is easily changed into the carbonate may also be poi- 
sonous by conversion into the carbonate in the stomach. 
This may be obviated by administering an excess of vine- 
gar, or acetic acid with the acetate. 

What are the tests for lead ? The hydrosulphuric acid. It 
is also separated from its salts in the metalic form by iron, or 
zinc. The lead is deposited forming the arbor Saturni. 

How is peroxide of lead procured ? By the action of ni- 
tric acid on minium, which dissolves the protoxide and 
leaves the peroxide ; and by passing a current of chlorine 
through a solution of acetate of lead. This oxide is of a pure 
brown color, insoluble in water, does not unite with acids, 
and is resolved into a salt of the protoxide, and oxygen 
gas by strong ox-acids. 

How is the red oxide or minium procured'? By heating 
the protoxide nearly to redness, and suffering it to cool 
slowly. 

What are the properties of the red oxide ? It does not 
unite with acids, gives off oxygon when heated to redness, 
and is converted into the protoxide: it is resolved into pro- 
toxide and peroxide by nitric acid. 

What other compounds are formed with lead? The 
chloride, iodide, bromide, fluoride, sulphuret, phosphuret 
and carburet of lead. 

Mercury or Quicksilver, 

How is mercury found in nature? It is found native, 
combined with sulphur as cinnibar, which is its most abun- 
dant form; amalgamated with silver; and as a chloride. 

How is it procured, and from where? By heating the 
sulphuret with lime, or iron filings, by which means the 
mercury is volatalized, and the sulphur retained. To pu- 
rify it it may be digested with sulphuric acid. It is brought 
principally from Spain, Hungary, Asia, and South America. 

What are its properties? It is fluid at common tempera- 
tures, of a tin white color, and has a strong metalic lustre. 
It freezes at 39 or 40 s below zero; boils at about 662°, and 
does not tarnish by exposure to the air if perfectly pure. It 
is acted upon by nitric and hot sulphuric acids. Its eq. is 
202; sp. gr. fluid 13.568; frozen 15.612; symbol Hg, 

What are the compounds of mercury and oxygen ? There 
11* 



CHEMISTRY. 



are two, the protoxide, which is 1 eq. of mercury and 1 eq> 
of oxygen; and the peroxide, which is 1 eq. of mercury: 
and 2 eq. of oxygen. 

How is the protoxide of mercury procured] By mixing 
calomel, or protochloride briskly, with an excess of potassa, 
the oxygen and chlorine exchange places, and chloride of 
potassium, and the protoxide of mercury are formed. It 
may also be procured by adding an alkaline solution to the 
nitrate of the protoxide of mercury. 

What are the properties of the protoxide of mercury ? 
It is a black powder, easily decomposed, unites with acids, 
but is a weak base. The nitrate is decomposed by alkalies, 
which throw down the protoxide; by alkaline carbonates 
throwing down the white carbonate; by hydrochloric acid, 
or any soluble chloride, and the potochloride, or calomel is 
formed ; and by hydro-sulphuric acid, and the black proto- 
sulphuret is produced. 

How is the peroxide procured? By the action of heat 
and air combined; by dissolving mercury in nitric acid; 
and by exposing the nitrate to a heat sufficient to expel 
the nitric acid. It is the red precipitate of popular lan- 
guage. 

What are the properties of the peroxide ? It is in. shining 
crystalline scales, when hot it is nearly black, and red when 
cold; finely powdered it is of an orange color; when heated 
to redness it is resolved into metalic mercury and oxygen. 
It is separated from acids by ammonia and its carbonate, as 
a white precipitate. 

What are the compounds of chlorine and mercury? They 
are the protochloride or calomel, which is 1 eq. of mercury 
and 1 eq. of chlorine ; and the bichloride or corrosive sub-* 
limate, which is 1 eq. of mercury, and 2 eq. of chlorine. 

How is the protochloride or calomel procured? It is gen- 
erated when mercury and chlorine come in contact at com- 
mon temperatures, by the union of mercury and the bichlo- 
ride, which should be sublimed, and by mixing the nitrate 
of the protoxide with hydrochloric acid, or a soluble 
chloride. 

What are its properties? It is white, crystalline, com- 
pact, tasteless, inodorous, and not altered by exposure to the 
atmosphere if light is excluded ; but by this it is rendered 
black and partially reduced to the metalic state; alkaline 
solutions render it black by the formation of the protoxide. 



CHEMISTRY, 



123 



How is the bichloride procured? By heating mercury in 
chlorine gas, and by subliming a mixture of 298.2 parts of 
the bisulphate of the peroxide of mercury with 117.44 parts 
of the chloride of sodium. The products of this last pro- 
cess are 1 eq. of the bichloride of mercury, and 2 eq. of the 
sulphate of soda. 

What are its properties? It is white, semi-transparent, 
crystalline and poisonous; has an acid, burning taste, and 
loaves a nauseous, metalic one. It is slightly soluble in 
cold water, and highly soluble in hot water and alcohol. 
By the addition of ammonia to its solution, the white pre- 
cipitate is formed. 

What are the tests for corrosive sublimate? Hydrosul- 
phuric acid precipitates the black sulphur et of mercury; 
lime water and the pure fixed alkalies a yellow peroxide of 
mercury; hydriodate of potassa precipitates the deutoiodide 
of mercury, which is of a pale scarlet color and resembles 
no other iodide; another is to place a drop of the suspected 
liquid on polished gold, and touch it through the liquid 
with a piece of iron wire or point of a knife, when the part 
touched instantly becomes white, which is caused by an 
amalgam of gold. Albumen or white of eggs produces a 
white floculent precipitate, which is _a compound of calo- 
mel and albumen, and is inert; therefore white of egg? is 
an antidote for poisoning by corrosive sublimate. 

What are the iodides of mercury? They are the protoi- 
odide, which is mercury 1 eq., and iodine 1 eq. ; and is ob 
tained by mixing the nitrate of the protoxide of mercury 
with the iodide of potassium. It is a greenish powder in- 
soluble in water. 

The sesqui-iodide, which is 2 eq. of mercury to 2 eq. of 
iodine, and is obtained by adding the iodide of potassium 
in solution to a mixture of the nitrates of the protoxide and 
the peroxides of mercury; 

The biniodide which is 1 eq. of mercury, and 2 eq. cf 
iodine ; and is obtained by adding the iodide of potassium 
in. solution to the nitrate of the peroxide, or to the bichloride 
of mercury. It is precipitated as a rich red colored pow- 
der yieing in beauty with the vermillion. 

What are the compounds of mercury and sulphur? The 
protosulphuret, which is 1 eq. of mercury to 1 eq. of sul- 
phur; and may be formed by passing hydrosulphuric acid 
gas through a solution of the nitrate of the protoxide of 
mercury, or through water with calomel suspended in it. 



CHEMISTRY. 



Tho bisulphurot, which is 1 eq. of mercury, to 2 eq. of 
sulphur; and is formod by fusing sulphur with six times its 
weight of mercury, and subliming in close vessels. This is 
fictitious cinnibar, and when powdered it forms the beau- 
tiful pigment vormillion. 

What is ethiops mineral? It is a mixture of sulphur, and 
tho bisulphuret of mercury, and is formod by triturating to- 
gether equal parts of mercury and sulphur. 

What compound does mercury form with cyanogen? A 
bicyanide, obtained by boiling tho red oxide of mercury 
with Prussian blue. 

Silver. 

How is silver found in naturo, and whero? It is found 
native, and in combination with sulphur in galena, also com- 
bined with gold, antimony, copper, &c. Nearly all the lead 
of commerce contains traces of silver. It is found in Mex- 
ico, Peru, and Hungary. 

How is it procured? By amalgamation, and cupellation, 
depending upon the form of ore used. It may be obtained 
pure from coin by dissolving it in nitric acid, and decom- 
posing the nitrate. 

What aro its properties? It is the clearest white of tho 
motals, receives a beautiful polish, is very malleable, duc- 
tile, quite tenacious, soft when pure, and when fused in 
open vessels it absorbs oxygen. It is blackened by sulphur 
and chlorine. Its equivalent 108; specific gravity 10.51; 
symbol Ag. 

What are the compounds of silver and oxygen? They 
are tho protoxide, which is 1 eq. of silver, and 1 eq. of oxy- 
gen; and is obtained by decomposing the nitrate by potash 
or soda. It is of a deep olive color, soluble slightly in wa- 
ter, and forms a fulminating compound with ammonia. It 
is precipitated in the metalic state by most of the metals; 
when mercury is employed it assumes anarboresent appear- 
ance called arbor Dianae. And the peroxido, which is un- 
important in its chemical relations. 

How is the nitrate of silver procured? By the action of 
nitric acid on silver; when it has been fused it is called lu- 
nar caustic. 

What is tho best test for silver? Chlorine, and tho muri- 
ates, which form an insoluble chloride. 

How is the chloride of silver prepared? It sometimes 



CHEMISTRY, 



125 



occurs native j and is called horn silver; it is generated when 
silver is heated in chlorine gas, and may be precipitated by 
adding hydrochloric acid, or a soluble chloride to the nitrate 
of silver. 

What are its properties? It is white, insoluble in water, 
slightly soluble in acids, but very soluble in ammonia, and 
is decomposed by hydrogen. 

How is the iodide of silver procured) By adding the 
iodide of potassium to a solution of the nitrate of silver. 
It is greenish yellow, and is soluble in water and ammonia. 

How is the sulphuret of silver procured? Silver unites 
with sulphur on exposure to hydrosulphuric acid, and by 
transmitting this gas through a solution of the nitrate, 
when it subsides as a dark brov/n precipitate, the eulphurot 
of silver. 

How is gold found in nature, and where? It is found 
pure and in combination with other metals in North and South 
America, Hungary, and Liberia. 

How is gold obtained pure? By amalgamation with mer- 
cury, and then distilling oft the mercury; by making a solu- 
tion in nitro-hydrochloric acid, and precipitating it by the 
sulphate of iron. 

What are the properties of gold? It has a yellow color 
which distinguishes it from all other simple metals, is very 
malleable and ductile, but inferior to several in brilliancy 
and tenacity. It has but little affinity for oxygen or sul- 
phur. Its equivalent is 199.2; sp.gr/l9.257; symbol An, 
Its solvent is chlorine to which the nitro-hydrochloric acid 
owes its solvent powers. 

What are tho oxides of gold? The protoxide, 1 eq. of 
each; the binoxide, 1 eq. of gold to 2 eq. of oxygen; and 
the teroxide, 1 eq. of gold, to 3 eq. of oxygen. 

What is the test for gold in solution. 'The protochlorido 
of tin, wmich throws down the purple of Cassias. 

PLATIXU3I, 

How is platinum found in nature, and where? In the me- 
talic state, associated or combined with other metals. It is 
found in South America, and in the Uralian mountains. 

How is it obtained? By dissolving the native grains of 
platinum in aqua regia s or nitro-hydrochloric acid, and ad- 



CHEMISTRY. 



ding to it a solution of sa! ammoniac, which affords an or- 
ange yellow precipitate. This is to be washed, dried and 
exposed to a red heat, which isolates the metal in a porous 
state, called platina sponge; which may be consolidated by 
mechanical pressure, heat, and hammering. 

What are the properties of platinum? It has a white color, 
with a lustre inferior to silver, is malleable, ductile, may be 
welded at high temperatures, and is difficult of oxidation, or 
fusion. Chlorine, or solutions which afford it is its proper 
solvent. It is the heaviest of known metals, sp. gr. 21.5, 
eq. 98.8, symb. PL 

What are the compounds of platinum? There are three 
oxides, two chlorides, two iodides, and two sulphurets. 

What is the test for platinum ? Proto-chloride of tin, 
which throws down a claret colored precipitate. 

Alloys and Amalgams. 

What is meant by alloys, and amalgams? Alloys are com- 
binations of the metals with each other, and when mercury 
is a constituent they are called amalgams. 

Under what circumstances do metals combine with each 
other? It is necessary that at least one of them should be 
liquid, when they will unite if the attraction is energetic. 

Do they combine in definite proportions only? They unite 
in all proportions; yet there appears to be a tendency to 
unite in definite proportions, as some compounds of this 
kind occur native. 

What are the general properties of alloys? They resem- 
ble the metals, are opaque, possess metalic lustre, and are 
good conductors of heat, and electricity. The color is some- 
times changed from that of its constituents; the hardness is 
generally increased, consequently the sonorousness is in ge- 
neral increased, the malleability, and ductility are usual- 
ly impaired; the density is sometimes greater, sometimes 
less; the fusibility is greatly increased, and the tendency to 
unite with oxygen augmented. 

Salts. 

How is the class of salts divided? Into four orders: 

Order 1st. Tho oxy-salts; or those salts the acids or bases 
bases of which are oxidized bodies. 

Order 2d. The hydro-salts; or those salts tho acids or ba- 
ses of which contain hydrogen. 

Order. 3d. The sulphur-salts ; or those salts the electro-posi- 
live or negative ingredients of which arc sulphurets, 



CHEMISTRY, 



Order 4th. The haloid salts; or those salts the electro-posi- 
tive, or negative ingredients of which are haloidal. 

What is meant by deliquescent salt? It is where a salt 
attracts moisture, and becomes liquid. 

What by an efflorescent salt? It is where a salt loses its 
water of crystalization,and falls down into a white powder, 

What is the water of crystalization? It is water which 
unites with a salt in crystalization, and forms a part of the 
crystal, but is not an essential ingredient to the existence of 
the salt. 

What are the characteristics of the sulphates? In solu= 
tion a white precipitate (the sulphate of baryta), is thrown 
down by the chloride of barium, which is a test for sulphu- 
ric acid, free, or combined. 

They are soluble" with the exception of the sulphatos of 
baryta, of the oxides of tin, antimony, bismuth, lead, and 
mercury. Those sparingly soluble, are the sulphates of stron- 
tia, lime, zirconia, yttria, and of the oxides of cerium^ and 
silver. The other sulphates are quite soluble in water. 

What are the characteristics of the sulphites? The sul- 
phuric, hydrochloric, phosphoric, and arsenic acids decom- 
pose the sulphites with effervescence, owing to the libera- 
tion of sulphurous acid gas; they are converted by nitric 
acid into sulphates. 

What is the prominent characteristic of the nitrates? 
They are decomposed invariably at a high temperature. 

What is the prominent characteristic of the nitrites? By 
the addition of a strong acid the red fumes of nitrous acid 
are disengaged. 

What is the characteristic of the chlorates? They are de- 
composed at a red heat, oxygen gas is evolved, and a chlo- 
ride is formed. 

What characterizes the chlorites? They are soluble in 
water, and possess high bleaching, and oxidizing properties. 

What characterizes the iodates? They are similar to the 
chlorates, iodides being formed of course, instead of chlorides 
when heated. 

What characterises the arseniates? When heated to red- 
ness with charcoal they are decomposed, and metalic arsen- 
ic is set at liberty. 

What characterizes the chromates? They are generally 
eithor of a red or yellow color, are decomposed by heat, and 
the acid is resolved into green oxide of chromium, and oxy- 
gen gas. 



120 



CHEMISTRY, 



What characterizes the carbonates? Their decomposition 
with effervescence by nearly all the acids, and most of them 
are decomposed by heat. 

How may the salts of ammonia be distinguished? By 
the addition of pure potassa, when the odor of ammonia is 
given off. 

How may the hydrosulphates be distinguished? By hy- 
drosulphuric acid being expelled with effervescence by oth- 
er acids. 

ORGANIC CHEMISTRY. 

What is understood by organic chemistry? It compre- 
hends the history of those compounds which are of animal, 
or vegetable origin. 

What are the simple elements coming under notice in or- 
ganic chemistry? They are carbon, hydrogen, oxygen, and 
nitrogen, with traces of phosphorus, sulphur, iron, silicic 
acid, potassa, lime, &c. 

Are organic substances liable to decomposition? Yes; 
they are very prone to decomposition, the tendency of car- 
bon, and hydrogen being to appropriate to themselves as 
much exygen as will form carbonic acid and water; and 
when the oxygen is insufficient, carbonic oxide, and carbu- 
rottcd hydrogen are formed. When the organic substance 
contains nitrogen it is very prone to decomposition, and 
water, carbonic acid, hydrocyanic acid, and ammonia are 
formed. They are all decomposed at a red heat, and nearly 
all below this temperature. 

What are the particular characteristics of organic pro- 
ducts? They are composed of the same elements, undergo 
spontaneous decomposition with facility, cannot bo formed 
by the direct union of their elements, and are decomposed 
at a rod heat. 

Vegetable Chemistry. 

What are the simple elements of vegetable substances? 
Oxygen, hydrogen, carbon, and a few contain nitrogen. 

What is meant by the proximate, or immediate principle 
of vegetables? They are compounds which exist ready for- 
med in plants, such as sugar, starch, and gum. 

What is meant by the proximate analysis of vegetables? 
It is the procees of separating the proximate principles from 



CHEMISTRY, 



129 



each other, and the reduction of the proximate principles 
into their simplest parts constitutes their ultimate analysis, 
How may vegetable substances be arranged? Into the 
vegetable acids, the vegetable alkalies; neutral substances* 
the oxygen and hydrogen of which are in the ratio to form 
water; the oleaginous, resinous, and bituminous principles; 
the spirituous, and ethereal principles; coloring matter; and 



sesslng acid properties, which are the products of vegeta- 



What are the general properties of vegetable acids? 
They are decomposed at a red heat, less liable to spontane- 
ous decomposition than other vegetable substances, decom- 
posed by hot nitric acid, by which they are converted into 
carbonic acid and water. 



times it is even in a less proportion as in benzoic acid; but 
when there is more oxygen than suffices to form water with 
hydrogen, the vegetable substances are always acid. 

Where is Oxalic acid found? In several plants ready for- 
med as in the rum ex acetosa or common sorrel; the oxalie 
acstosella or wood sorrel; and it may be prepared by digest- 
ing sugar with nitric acid. 

What are the properties of oxalic acid? It crystalizes in 
slender flattened four ana six sided prisms, terminated by 
six sided summits, but the primary form is an oblique rhom- 
bic prism; it has a sour taste, reddens litmus, and forms neu- 
tral salts with alkalies, and is very soluble in water. 

It is powerfully poisonous, and is frequently taken by mis- 
take for epsom salts, which it resembles. Chalk is its anti- 
dote with which it forms an insoluble oxalate of lime. 

It is distinguished from all other acids by the form of its 
crystals, and by its solution giving with lime water a white 
insolubu precipitate. 

Where is Acetic acid found? It exists in the sap of many 
plants, either fre^, or combined; it is generated by the de- 
structive distillation of vegetable matter, and is produced by 
the acetous fermentation. It is best obtained pure and 




Is oxygon al 
water, in veget 



portion above that for forming 
snerally, but not always; some- 



CHEMISTRY 



concentrated by decomposing the acetates by. sulphuric 
acid. For chemical purposes it is obtained by the destruc- 
tive distillation of wood, and sold under the name of pyro- 
ligneous acid. 

How is acetic acid distinguished? By its flavor, odor, 
and volatility. Its salts are called acetates, and arc all solu- 
ble in hot and most of them in cold water. 

Where is Lactic acid found ? In sour milk, and in the 
beet root. 

Yv'here is Kinic acid found? In cinchona bark in combi- 
nation with lime, quinia, and cinchona. 

Where is Malic acid found? In the acidulous fruits, such 
as grapes, oranges, currants, apples, &c. 

Where is Citric acid found ? In the juice of the lime, 
and lemon. 

From what is Tartaric acid procured ? It, exists in the 
juice of some of the acidulous fruits, but generally in com- 
bination with lime or potassa. 

It is prepared by mixing chalk with cremor tartar from 
which the tartrate of lime is thrown down, and the tartrate 
of potassa remains in solution; to the tartrate of lime sul- 
phuric acid is added, and the tartaric acid is set at liberty. 

What are the properties of tartaric acid? It has an agreea- 
ble sour tasts, reddens litmus, and forms with alkalies neu- 
tral salts called tartrates It is distinguished by forming a 
white precipitate, the bitartrate of potassa' when mixed with 
any of the salts of potassa; it therefore separates potassa 
from tho other acids, and produces a precipitate with lime, 
which is soluble in an excess of the acid. It is remarkable 
in forming double salts, the most important of which, are 
those of potassa and soda, or the Rochelle salt, and of ox- 
ide of antimony and potassa, or tartar emetic. 

What is the cream of tartar of the shops? It is the bi- 
tartrate of potassa; in an impure state known by the name 
of tartar,it is found encrusted oh the sides and bottom of 
wine casks; being insoluble in alcohol, it is deposited as 
alcohol is formed during the vinous fermentation. 

Where is Benzoic acid found? In gum benzoin, storax, 
balsam of" Peru, Tolu, &c; also in the urine of tho cow, 
and of children, it is generally procured from gum benzoin. 

Where is Meconic acid found ? It is found only in opium 
combined with morphia. It is known by forming with the 
sesqui-salts of iron a purple-red color, which renders it 
valuable as a test for opium. 



CHEMISTRY, 



13) 



Where is Tannic acid or Tannin found ) In the excrescen- 
ces of the oak called gall nuts, in the bark of most trees, in 
kino, catechu, the tea plant, sumach, uva ursi, and in astrin- 
gent plants generally ; it is the principal cause of astringen- 
cy in vegetables. 
" What are the properties of tannic acid? 

It is colorless, inodorous, has an astringent taste, no bit- 
terness, and may be kept in the solid state. It is soluble, 
reddens litmus, and decomposes the carbonates. It strikes 
a deep blue precipitate with the sesqui-salts of iron, but not 
with the proto-sahs, which distinguishes it from all other 
substances except gallic acid, and from this it may be dis- 
tinguished by yielding with a solution of gelatin, a white 
flaky precipitate soluble in a solution of gelatin, but insolu- 
ble in water and gallic acid. This compound of tannic 
acid and gelatin called tanno-gelatin, is the basis of leather. 

Where is Gallic acid found] In most substances which 
contain tannic acid, and is probably developed by the oxi- 
dation of that acid. It does not precipitate gelatin or the 
salts of the vegetable alkalies. 

How is the succinic acid obtained? By heating powdered 
amber in a retort. 

Vegetable Alkalies. 

What is understood by vegetable alkalies ? They are 
those proximate vegetable principles which possess alkaline 
properties. They all contain nitrogen, are decomposed by 
a moderate heat, and are but slightly soluble in water. 

What [is their composition? Carbon, hydrogen (in 
greater proportion than to form water,) nitrogen, and oxy- 
gen ; and they always exist in combination with an acid. 

How are they generally procured ? The substance con- 
taining the alkaline principle is digested or macerated in a 
large quantity of water to dissolve the salt, of which the 
alkali is the base. Then add a powerful salifiable base 
which unites with the acid, the alkaline base is set at lib- 
erty, may be collected on a filter, purified by solution in 
boiling alcohol, and evaporated to dryness. 

What are some of the most prominent vegetable alkalies? 
Morphia, narcotina, codeia, narceia, cinchonia, quinia, ari- 
cina, strychnia, brucia, veratria, enietia, and delphia. 

Where is Morphia found in nature? It is the medicinal 
agent of opium, in which it is combined with mecoi^c and 
sulphuric acids, and other foreign matter:. 



138 



CHEMISTRY. 



What aro the properties of morphia.'? Colorless crystals 
of a brilliant lustre, and in irregular six sided prisms, may 
be obtained from the alcoholic solution. It is insoluble in 
cold, and slightly in hot water, tasteless when pure, but 
very bitter when dissolved in alcohol, or rendered soluble 
by means of an acid. Strong nitric acid converts it into 
oxalic acid, and with a sesquisalt of iron it strikes a blue 
tint. It is almost inert when pure from its insolubility, but 
when in solution it acts with groat energy. By decompo- 
sing a salt of morphia, when taken into the stomach, by am- 
monia, the effects of an over dose may be prevented. It 
decomposes iodic acid, and sets iodine, free which may bo 
recognized by starch its appropriate test; one grain of pure 
morphia in 7000 grains of water may be recognized by this 
test. 

Where 'are Cinclionia, and Quinia found? In the cin- 
chona bark, in union with kinic acid. 

How are they procured.? By taking up the soluble parts 
of the bark by hot water acidulated with hydrochloric acid; 
concentrate the solution, and digest with successively added 
portions of slaked lime until the liquid becomes alkaline. 
The precipitate is carefully collected, and the vegetable 
alkali separated by boiling alcohol. 

What are the properties of cinclionia? When pure it 
crystallizes in colorless quadrilateral prisms, insoluble in 
cold, slightly soluble in hot water, and very soluble in boil- 
ing alcohol. It has a very bitter taste when dissolved by 
alcohol, or an acid; and forms salts with acids. 

What are the properties of quinia or quinine? It is pre- 
cipitated from its solutions by alkalies in white flocks, 
which do not crystallize; very soluble in alcohol, and ether, 
but very slightly so in water. Its medicinal virtues aro 
more powerful than those of cinchonia. It forms salts with 
acids, the most important of which is the disulphate and is 
prepared in large quantities for medical purposes, crystal- 
lizing in delicate white needle shaped crystals. 

The sulphate of quina is frequently adulterated; and the 
substances generally employed are water, sugar, starch, 
gum, ammoniacal and earthy salts. When pure it should 
only loose 8 or 10 per cent of water of crystallization by 
heat. The other impurities may be detected by the appro- 
priate means. 

Where is Strychina found? In the fruit of the strychnos 



CHEMISTRY. 



133 



ignatia, and the strychnos nux vomica, and has also boon 
extracted from the Upas. 

What are tho properties of strychnia? It is soluble hi 
boiling alcohol, and by evaporation it is procured in four 
sided prisms. It is a virulent poison, producing jleath in a 
very short time if taken in sufiicient quantity. Its action is 
accompanied by tetanic symptoms. 

Neutral Substances, the Oxygen and Hydrogen of which 

are in the same ratio as in Water. 
What substances are included in this class? Sugar, 
Maanite, Wheat Starch, Potato Starch, Gum Arabic, and 
Lignin. 

Oleaginous, Resinous, and Bituminous Substances. 

What is remarkable in this class of bodies?- Their com- 
bustibility, besides other properties common to each. They 
generally contain hydrogen in a larger proportion than rs 
necessary to form water with their oxygen, and they exert 
a feeble affinity for other bodies. 

What are the characteristics o f%ils ? They are inflamma- 
ble, havo a peculiar unctious feci, and are insoluble in wa- 
ter. They are divided into fixed and volatile; the former 
gives a permanent greasy stain to paper; and the latter pro- 
duces one which disappears by a gentle heat. 

Where are fixed oils usually found ? In the seeds of 
plants, but olive oil is procured from tho pulp which sur- 
rounds the stone. These oils are obtained by burning the 
seeds, and subjecting the pulpy matter to pressure and a 
gentle heat. 

They absorb oxygen, and become rancid when exposed 
to the atmosphere, or to oxygen gas; they also unite with 
alkalies and form soap. 

What are their component parts ? Tuargarine or the hard 
portion; and clainc or oleine. 

Where are volatile or essential oils found ) In aromatic 
plants, from which it is obtained by distillation. 

What oil is procured from bitter almonds ? When bruis- 
ed and subjected to compression it yields a pure fixed oil; 
but when distilled with water a poisonous volatile oil 
passes over which contains hydrocyanic acid, 
Resinous Substances. 
What are resins? The inspissated juices of planus 

12* 



134 



CHEMISTRY 



either puro or in combination with essential oils. They 
are solid, brittle, inodorous, insipid, and generally of a yel- 
low color; semi-transparent, non-conductors of electricity, 
and negatively electric when rubbed. 

The most important of the resins are common resin, co- 
pal, lac, sandrach, mastich, elemi, and dragons blood. 

What are balsams?- They are compounds of resin and 
benzoic acid. 

What are gum-resins? They are the concrete juice of 
plants which contain resin, essential oil, gum, and extrac- 
tive matter. Their proper solvent is proof spirit. Under 
this head are aloes, ainmoniacum, assafoetida, euphorbium, 
galbanum, gamboge, myrrh, scammony, and guiacum. 

Bituminous Substances. 

How are bituminous substances divided ? Into bitumen 
and pit coal; under the first head are naphtha, petroleum, 
mineral tar, asphaltum, mineral pitch, and retina-sphaltum ; 
and under the latter head are brown coal, common or black 
coal, and glance coal or anthracite. 

SPIRITUOUS AND ETHEREAL SUBSTANCES. 

Alcohol. 

Is alcohol the intoxicating ingredient in all spirituous and 
vinous liquors? It is; and is always a product of the vinous 
fermentation; therefore does not exist ready formed in 
plants. 

How is the alcohol procured pure? By the addition of 
heated carbonate of potash, (or any other substance having 
a strong affinity for water,) to spirit of wine ; the potash 
unites with the water subsides, and the alcohol may bo de- 
e arited pure. 

Ether. 

How is ether procured? By heating the stronger acids 
with alcohol; the different kinds are distinguished by the 
name of the acids used in their preparation. 

Coloring- Matters. 

What are the prevailing colors of vegetables? Red, yel- 
low, blue, and green, or their mixtures. 

Does vegetable coloring matter occur in an insulated 
Ptate? No; it is always attached to some proyimate prin- 



CHEMISTRY. 



135 



ciple, such as mucilaginous, extractive, or resinous sub- 
stances, by which its properties are influenced. 

It is generally decomposed by the combined agency ot 
the sun's rays, and a moist atmosphere; and all of them 
are destroyed by chlorine. 

What is meant by lakes] They are insoluble compounds 
formed by coloring matter with some of the metalic oxides. 

What is meant by the term mordant or basis ? It is a 
substance having an affinity both for the coloring matter, 
and the article to be colored; which by combining with 
each at the same time causes the dye to be permanent. 

Those coloring substances which adhere to the cloth 
without a basis, are called substantive colors, and thoso 
which require a basis, adjective coiors. 

What substances produce the blue dyes? Indigo. 

What the red? Cochineal, lac, archil, madder, brazil 
wood, logwood, and safflower. 

The yellow? Quercitron bark, turmeric, wild American 
hickory, fustic, and saffron; all of which are adjective colors. 

The black ? The same ingredients as writing ink, and is 
therefore essentially oxide o£iron with gallic acid and tan- 
nin. 

Substances which do xot beloxg- to either of the preced 
ixg sectioxs. 

What are the articles belonging to this clas>? Vegeta- 
ble albumen, gluten, yeast, asparagin, bassorin, caffein, ca- 
thartln, fungin, suberin, uloiin, lupulin, inulin, medullin, 
piperin, olivile, sarcocoll, rheubarbarin, rhaponticin, eolo- 
cyntin, berberin, bryonin, gentianin, zanthopicrin, scillitin, 
se-negin, saponin, arthanatin, plumbagin, ehlorophylo, 
amyo-dalin, salicin, populin, meconin, columbin, elatin, sina- 
pism, &,c. 

SrCNTAXEOUS CHAXCrES OF VEGETABLE MATTER. 

WMat is Fermentation? It is certain spontaneous changes 
which vegetable substances undergo when the- vital princi- 
ple is extinct. It is divided into four distinct kinds, viz : the 
saccharine, vinous, acetous and putrefactive. 

What substances undergo the saccharine fermentation? 
Starch is the only one kn>wn to be subject to this fermenta- 
tion, which takes place when it is kept in a moist state for 
some tima; a-nd sugar equal to half the weight of the starch 
employed is formed. 



136 



CHEMISTRY. 



What circumstances arc necessaiy to the vinous fermen- 
tation] The presence of sugar, water, yeast, or some fer- 
ment, and a certain temperature. The changes which take 
place are the disappearance of sugar, the formation of alco- 
hol, and the escape of carbonic acid gas. 

Under what circumstances does the acetous fermentation 
take place ? When a liquid which has undergone the vi- 
nous fermentation is mixed with yeast, and exposed to the 
open air. In this process oxygen is absorbed, and carbonic 
acid gas is disengaged 

What circumstances are necessary to the putrefactive fer- 
mentation] The accompanying circumstances which ena- 
ble this process to take place, ar<3 moisture, air, and a cer- 
tain temperature ; the most favorable temperature is between 
60 and 100 degrees. 

The principal products are water, light carburetted hydro- 
gen, carbonic acid, and when nitrogen is present, ammonia. 
The solid remains aro charcoal combined with oxygen, and 
hydrogen. 

Germination. 

What conditions are necessary to germination ? Moisture, 
a certain temperature, and oxygen gas. Light, which is fa- 
vorable to the subsequent stages of vegetation, is injurious 
to germination. 

Animal Chemistry. 

What is meant by proximate animal principles? They 
are distinct compounds derived from che bodies oi animals. 

How are they distinguished from vegetable matter? By 
the presence of nitrogen, their strong tendency to putrelV, 
and the offensive products of putrefaction. Some vegetable 
principles contain nitrogen, but they not putrefy readily. 

What are the essential constituents of animal compounds? 
Carbon oxygen, hydrogen, and nitrogen; besides, some of 
them contain phosphorus, sulphur, Jron, earthy and saline 
matters. 

What effect has heat upon them when applied in a close 
vessel? They yield water, carbonic oxide, carburetted hy- 
drogen, carbonate and hydrocyanato of ammonia, a foetid, 
thick oil, and carbonaceous matter, which is a powerful de- 
colorizing agent. 

What is the principle of the mode of analyzing animal 



CHEMISTRY. 



137 



and vegetable substances. It is to convert the whole of the 
carbon contained, into carbonic acid, and the hydrogen into 
watt r. 

How are animal products divided? 1st. Into those which 
are neither acid nor oleaginous; 2d. the acids; and 3d. the 
oils, and fats. 

What substances are included in the first division ? Fi- 
brine, albumen, gelatin, urea, sugar of milk, and sugar of 
diabetes. 

In what does Fibrin exist?- In muscle, chyle, and blood. 
It is solid, white, insipid, and inodorous. 

Where is Albumen fjnnd ? In the white of eggs, and in 
the serum of the blood. 

What are the properties of albumen? It is precipitated 
by corrosive sublimate, which is its best t?st; and it is co- 
agulated by heat, alcohol, and the stronger acids. 

Where is Gelatin found? In the skin, cartilages, mem- 
branes, and bones. 

What are its properties? it is readily soluble in water, 
and forms a jtlly when cool; it is known in commcice by 
the name of glue; tannic acid is its appropriate test. 

Where is Urea found? It is procured from fresh urine. 

What are the proximate principles of animal oils? Stea- 
rine, margarine, and oleine. 

What circumstances are necessary to the putrefaction of 
animal substances? Water, air, and a certain temperature. 

What are the products of putrefaction? Water, ammo- 
nia, carbonic and acetic acids, carburetted and sulphuretted 
hydrogen, and phosphuretted hydrogen in some cases. 

ANALYTICAL CHEMISTRY. 
By what process do you analyze a gaseous mixture con- 
taining oxygen? Introduce into the mixture a quantity of 
hydrogen, more than sufficient to saturate the oxygen pres- 
ent, carefully measure the whole, pass an electric spark 
through it, or introduce, into it a piece of spongy platinum, 
and note the diminution; divide the diminution by 3, and 
you have the quantity of Oxygen originally in the mixture. 

What is the process when the quantity of nitrogen is to 
be determined? The method is to withdraw all other gase- 
ous substances with which it is mixed. - 

What is the mode of determining th ? quantity of carbon- 
ic acid in gaseous mixtures? 



130 



CHEMISTRY. 



By agitating the mixture with lime water, or a solution of 
caustic potassa, and noting the deficiency. 

What is the mode of determining the quantity of hydro- 
gen? By causing it to combine with oxygen by the elec- 
tric spark, or platinum. The piinciple is the same for the 
inflammable gasses, chlorine being used for some of them 
instead of oxygen. 

TABLE OF SYMBOLS, AND CHEMICAL EQUIVALENTS OF 
ELEMENTARY SUBSTANCES. 

Ell 
Mercury 

drargyruirf 
Molybdenum 
Nickel 
Nitrogen 
Osmium 
Oxygen 
Palladium 
Phosphorus 
Platinum 
Potassium 

(Kalium) 
Rhodium 
Selenium 
Silver 

(Argentum) 
Silicium 
Sodium 

(Natrium) 
Strontium 
Sulphur 
Tellurium 
Thorium 
Tin 

(Stannum) 
Titanium 
Tungsten 

(Wolfram) 
Uranium 
'Vanadium 
jYttriurn 
Zinc 

Zirconium 



Ele. 


Bq. 


Sy. 


Alumiunim 


13.7 


Al 


Antimony 


64.(3 


Sb 


(Stibium) 






Arsenic 


37.7 


As 


Barium 


68.7 


Ba 


Bismuth 


71 


Bi 


Boron 


10.9 


B 


Bromine 


78.4 


Bi- 


Cadmium 


55.8 


Cd 


Calcium 


20.5 


Ca 


Carbon 


6.12 


C 


Cerium 


46 


Ce 


Chlorine 


35.42 


CI 


Chromium 


28 


Cr 


Cobalt 


29.5 


Co 


Columbium 


185 




(Tantalum) 




Ta 


Copper 


31.6 


Cu 


(Cuprum) 




Fluorine 


18.68 




Glucinium 


17.7 


F 


Gold 


199.2 


G 


(Aurum) 




Au 


Hydrogen 


1 


H 


Iodine 


126.3 


Iridium 


98.8 


I 


Iron 


28 


lr 


(Ferrum) 




Fe 


Lead 


103.6 




(Plumbum) 




Pb 


Lithium 


6.44 


L 


Magnesium 


12.7 






27.7 





Eg. 


Sy. 


202 ! 


Hg 


) 

47.7 


Mo 




Ni 


14.15 


N 


99.7 


Oa 


8 


O 


53.3 


Pd 


15.7 


P 


QQ P 


Ft 


39 15 


K 






39.6 


Se 


108 






Ag 


7.5 


Si 


23.3 


Na 


43.8 


Sr 


16.1 


S 


64.2 


Te 


59.6 


Th 


58.9 


Sn 


24.3 


Ti 


94.8 


W 


217 


U 


68.5 


V r 


32.2 


L 


3^.3 




33.7 


Zr 



PART III. 



MATERIA MEDICA AND PHARMACY. 



What is Materia Mediea? It is that science which treats 
of medicines. 

What is Pharmacy ? It is the art of preparing them for 
use. 

What are medicines?- They are substances capable of 



render thern applicable to the cure of disease. — Wood 

How may their operation be divided? Into their primary 

and secondary operation. 

In what way may the primary influence of medicines be 

exerted? 

1st. E} r nervous communication. 

2d. By entering the blood vessels, and acting through 
the medium of the circulation. 

3d. By acting exclusively in the neighborhood of their 
application. 

Have medicines in their operation an affinity for one part 
more than another] They have. Some substances act on 
the circulatory, nervous, or the absorbent system, and from 
the general distribution of these systems their action appears 
to be general. Others act upon the stomach, bowels, skin, 
kidneys, lungs, &c. ; the primary action of which are con- 
sidered to be local. This difference in their mode of action 
furnishes a basis for their division. 

What influences affecting the system may modify the ac- * 
tion of medicines? They are disease, climate, mode of 



140 



MATERIA MEBICA. 



life, habit, age, sex, temperament, idiosyncrasies, and men- 
tal operations, which should all be attended to in making 
prescriptions. 

What general rule is applicable in the doses of medicines 
according to age? For children under twelve years of age 
the doses of most medicines should be diminished in the 
proportion of the age to the age increased by 12. Thus at 
2 years to 1-7 ; viz : jjj 

4 2 x 12 — : at 4 years, to 1-4, viz : 

4 x 12~ 1-4. A full dose to be given at 21 years of age. 

Parish Phaimacologia. 

Some medicines such as castor oil, calomel, &c. may re- 
quire larger proportional doses. 

What is meant by the secondary effects of medicines ) 
They are changes which take place, not from the immedi- 
ate operation of medicines, but depend upon certain laws of 
the system which modify the primary actions, and condi- 
tions; and are very important in the treatment of disease. 
• In what forms are medicines used? In powders, pills, 
troches, electuaries, confections, mixtures, solutions, decoc- 
tions infusions, wines, tinctures, vinegars, syrups, honeys, 
oxymels, linaments, cerates, ointments, piasters, cataplasms, 
and in the state of vapor. 

To what parts of the body arc medicines applied? To the 
stomach, rectum, skin, bronchial tubes and pulmonary air 
cells, nostrils, inside of the mouth, and by injections into 
the bloodvessels. 

What are the objects in the application of medicines to 
the rectum? 1st. To produce alvine evacuations. 2d. Tu 
obtain their peculiar effects on the system. 

In the latter case it should be given in small bulk, so that 
it may remain in the bowels. The relative dose administer- 
ed in this way should be three times the ordinary quantity 
as a general rule. Medicines applied to the rectum are cal- 
led suppositories when solid; and when liquid, clysters, in- 
fections, or enema: i. 

What are the modes of application to the skin? They are 
various. The skin may be retained, or removed; the 
medicine may be used in the form of vapor, liquid, or a 
soft solid, and may be applied to the whole surface of the 
body, or a part. 

How are medicines applied to the bronchial tubes, &c? 
In the state of vapor. 



MATERIA MEDIC A. 



14! 



What objects are to be gained by their application to the 
nostrils? A powerful excitement of the brain, and a strong 
revulsion from neighboring parts. 

Classification. 

Upon what principle is the preferable mode of classifica- 
tion founded? On the relations which medicines bear to 
the human system in a healthy state. 

What is the first grand division in classification ? Into 
medicines which act on the living body, and those which 
act upon foreign matters contained in the body. 

How is the first grand division divided? Into those 
Bubstancea which act generally, and those which act locally. 

How are the general remedies divided? Into stimulants 
or excitants, and sedatives. 

How are stimulants divided? Into permanent, and diffu- 
sible. 

How are the permanent stimulants divided ? Into astrin- 
gents, and tonics. 

How are the diffusible stimulants divided? Into arterial 
stimulants, and cerebro-nervous stimulants. 

The latter may be again divided into cerebral stimulants 
or stimulant narcotics, and into nervous stimulants or anti- 
spasmodics. 

How are sedatives divided? Into arterial sedatives or re- 
frigerants, and nervous sedatives or sedative narcotics. 

How are the local remedies divided? Into those which 
affect the functions, those which affect the organization, and 
those which are mechanical in their action. 

Those affecting the function of a part, are 1st Emetics; 
2d. Cathartics; 3d. Diuretics; 4th. Diaphoretics; 5th. Ex- 
pectorants; 6th. Emmenagogues ; 7th. Sialagogues; and 
8th. Errhines. 

Those affecting the organization of a part, are 1st. Rube- 
facients; 2d. Epispastics; and 3d. Escharotics. 

Those operating mechanically, are 1st. Demulcents; 2d. 
Emollients; and 3d. Diluents. Then there are mercury, io- 
dine, arsenic, nux vomica, and ergot, which cannot be con- 
veniently classified. 

How is the second grand division divided? Into, 1st Ant- 
acids; and 2d, Anthelmintics. 
13 



142 



MATERIA MEDICA, 



TABULAR VIEW OF THE CLASSIFICATION 
As adopted by Prof. Wood of the University of Pennsylvania, 

Substances which- act on the living body, 
General remedies. 
Stimulants. 

Permanent stimulants. 
Astringents. 
Tonics. 
Diffusible stimulants. 
Arterial stimulants. 
Cerebro-nervous stimulants. * 
Cerebral stimulants, or stimulant narcotics. 
Nervous stimulants commonly called antispasmodics. 
Sedatives. 

Arterial sedatives or refrigerents. 
Nervous sedatives or sedative narcotics. 
Local remedies. 

Affecting the functions, 
Emetics- 
Cathartics. 
Diuretics. 
Diaphoretics. 
Expectorants. 
Emmenagogu3S. 
Sialagog ues. 

Affecting the organization, 

Rubefacients. 

Epispastics. 

Escharotics. 
Operating mechanically, 

Demulcents. 

Emollients. 

Diluents. 

Medicines insusceptible of accurate classification. 
Ergot. 

Nux vomica. 
Arsenic. 
Mercury. 
Iodine. 

Substances which act on foreign matters contained with- 
in the body. 

Antacids, Anthelmintics. 



MATERIA MEDICA. 



143 



Astringents, 

What is an astringent? A medicine which produces 
contraction of the living fibre. 

What are the general effects of astringents ? They produce 
greater firmness of muscle, diminished calibre, greater 
rigidity of the blood vessels and absorbents, and a diminu- 
tion or closure of secreting orifices and secretions generally. 
They produce moderate and permanent excitement of the 
organic life, but do not influence the nervous system much, 
or the functions of animal life. 

When are astringents indicated? In unhealthy discharges 
from the blood vessels, and in cases generally which de* 
pend upon relaxation of the tissues. 

When are they contra -indicated'? By the existence of 
any morbid condition of which 'the discharge is a mere 
effect, and which it is calculated to relieve; and by the ex- 
istence of any considerable local or general excitement.— 
In cases of excitement if i t be desirable to suppress a dis- 
charge they should be preceded by bleeding, or other de- 
pleting measures. Their external use is governed with 
some modification by the same rules, but may be admissible 
locally, when their internal use would not be justifiable. 

Under what circumstances may astringents be used lo- 
cally in eases of inflammation? In the commencement of 
inflammation before the excitability is much increased; or 
in the latter stages after it has become in some measure ex- 
hausted. 

How are astringents divided? Into the vegetable, and 
mineral. 

The former have an identity of character depending upon 
similarity of composition, the latter agreeing only in the 
property of astringency. 

Vegetable Astringents, 

Upon what proximate principle do vegetable astringents 
owe their peculiar property? Tannin or tannic acid; and 
they differ only in the proportion of this principle, and in 
the character of the other ingredients associated with it. 

What are the sensible properties of tannin? It is solid, 
uncrystallizable, white or slightly yellowish, strongly astrin- 
gent without bitterness, and it precipitates many of the me- 



144 



MATERIA MEDICA 



talic salts, with iron forms a black compound, and is 
incompatible with gelatin, with which it forms a precipitate. 

What is its dose? From 2 to 5 grs. every 3 or 4 hours. 

What are the officinal species of Quercus in the United 
States, from which oak bark is derived? The Quercus 
alba or white oak; and the Quercus tinctoria or black oak, 
are the only ones officinal in the United States; but this 
genus contains about eighty species, thirty or forty of which 
are found in the United States. 

How is the oak bark used? In powder, decoction, and 
extract. 

What is the dose? Of the powder 30 grains; the decoc- 
tion fgij ; extract, 20 grains. 

What are Galls, and where are they procured? Excres- 
cences on the young branches of the Quercus infectoria 
and other species, produced by the puncture of the Cynips 
quercusfolii ; the best are gathered early and are called 
blue, green, or black galls; the inferior are gathered later 
and are called the white galls. 

They are brought from Asia Minor and neighboring 
countries. 

How are galls generally used? As a local application ex- 
ternally, but may be used in powder, infusion, or decoction, 
and tincture. Dose of the powder 10 to 20 grains; of the 
infusion (made gss, to Oj) gij ; of the tincture f3ss to f3iij« 

What are incompatibles? Sulphuric and muriatic acids, 
gelatin, preparations irons, &c. 

What are the varieties of Kino? They are the African, 
Jamaica, Botany Bay, and East India or Amboyna kino. 
The East India is the kind most used. 

What are its general characteristics? As found in the 
shops it is in small irregular, angular, shining fragments of 
a dark reddish brown, or black color, and easily pulveriza- 
ble; contains tannin, and extractive matter. 

What are its medical properties and uses? It is powerful- 
ly astringent, and is much used where astringents are indi- 
cated. It may be given in powder, infusion, or dissolved in 
diluted alcohol. Dose of powder from 10 to 30 grains; of 
infusion (made by gij extract, and boiling water lb"£) fgj ; 
the amount of alcohol in the tincture renders it objectiona- 
ble. Incompatibles same as galls. 

From what is the Catechu procured? It is an extract of 
the wood of the Acacia Catechu, and comes from Hindostan. 



MATERIA MEDIC A. 



What are the general characters of catechu? It comes 
to us in masses of different shapes, of a rusty brown, varying 
from a reddish or yellowish brown to a dark liver color; 
contains tannin, extractive, and mucilage. 

What are its medicinal properties, and uses? It is tonic, 
powerfully astringent, and maybe given where astringents 
are indicate d. Dose from 10 grains to 3ss, and repeated 
fiequentiv. Incompatible^ same as galls. 

From what is Rhatany obtained?- From tho root of the 
Krameria triandria. It is a native of Peru. 

What are the general characters of rhatany? It comes to 
us in pieces of various shapes, and dimensions, often cylin 
drical, and two or three feet in length. The mineral acids, 
and most of the mineral salts are incompatible. Cold water 
by displacement extracts all the astringency from it. 

What are its medicinal properties, and uses? It is a gen- 
tle tonic, powerful astringent, and may be given where as- 
tringents are indicated. Dose of powder from 20 to 30 grs. 
of infusion, or decoction (made gj of bruised root to Oj of 
water), fgj ; of extract 15 or 20 grains ; tincture f3j to f 3iij ; 
and syrup f&s. 

From what is the Logwood procured ? From the Haema- 
toxylon Campeachianum, and is brought from Campeachy, 
the shores of Honduras Bay, and other parts of tropical 
America. 

W r hat are the general characteristics of logwood? It is 
hard, compact, heavy, of a deep red color, becomes dark by 
exposure, and has a sweetish astringent taste. Its peculiar 
principle is hematine* 

What are its medical properties and uses ? It is a mild 
astringent, well adapted to relaxed, and enfeebled conditions 
of the bowels. 

It is given in decoction, and extract, both of which are of- 
ficinal. Dose of the decoction fgij ; of the extract 10 to 20 
grains. 

From what is the Cranesbill derived? From the Gerani- 
um maculatum, an indiginous, perennial, herbaceous plant, 
growing in woods. The root is the part used, and should 
be collected in autumn; active principle, tannin. 

What are its medical pioperties, and uses? It is a power- 
ful astringent, and may be employed where they are indica- 
ted; it is very free from unpleasant qualities, which renders 
it serviceable for infants, and may be given in substance, 



14G MATERIA MEDIC A. 

decoction, tine Lure, or extract. Dose of powder 20 or 30 grg ; 
decoction (made gj to Ojss boiled to Oj), from fgj to fgvj. 

It is frequently given to children, boiled in milk. 

What is the officinal name of the plant furnishing the 
Blackberry root, and the Dewberry root ? The Rubus Vil- 
losus, and Rubus Trivialus, the virtues of which reside in 
the bark of the root. 

What are their medicinal properties and uses? Tonic, 
and strongly astringent. The decoction is prepared the same 
as the preceding article, and given in the same dose. Dose 
of powder, 20 to 30 grains. 

What is the plant furnishing the Uva Ursi? The Arbutus 
Uva Ursi, a small trailing evergreen shrub, growing plenti- 
fully in the U. S. as far south as New Jersey. The leaves 
are the part used. 

What are the general properties of the leaves'? They 
are inodorous when fresh, smell like hay when dried, 
have a bitterish taste, strongly astringent, and afterwards 
sweetish. The active ingredients are tannin, bitter extrac- 
tive, resin, gum, and gallic acid. 

What are its medical properties and uses? It is astringent, 
tonic, and thought by some to have a specific direction to 
the urinary organs. Dose of powder is from 9j to 3j ; Decoc- 
tion gj to gij, 3 or 4 times a day. 

What portion of the Pipsissewa or Chirnaphila umbellata 
is used in medicine? The leaves, and stem. It is a small 
indigenous evergreen plant growing in the north of Europe, 
Asia, and America-; inhabiting the woods. 

What are their general properties? The taste is pleasant- 
ly bitter, astringent, and sweetish. Boiling water and alco 
hoi extract the active properties of the plant, which are tan- 
nin, and bitter extractive. 

What are its medical properties and uses? Diuretic, ton- 
ic, and astringent. It is generally used in decoction, gj to 
Ojss of water boiled to Oj and taken in 24 hours. 

Mineral Astringents. 

What is the chemical composition of Alum? It is a sul- 
phate of alumina, and potassa. 

What are the incompatibles? The alkalies, lime, mag- 
nesia, and their carbonates; tartrate of potassa, and acetate 
of lead. 

What are its medical properties and uses? Astringent, 



MATERIA ME DIG A. 



147 



in ordinary medicinal doses, but purgative in large doses. 
It is used internally, and locally. The ordinary dose is from 
10 to 20 grains repeated every two or three hours. 

What are the preparations of Lead used medicinally ? 
They are the Litharge or Plumbi Oxidum Semivitrium, the 
Carbonate, the Acetate, and Sub-acetate. 

What are the effects of the combinations of lead? They 
are sedative, and astringent, and produce poisonous effects, 
if taken in large doses, or long repeated. The sulphate, and 
probably the acetate are exceptions to this. Sulphuric acid, 
sulphate of soda, and sulphate of magnesia are antidotes. 

What are the general properties of the Acetate of Lead ? 
It is a white salt crystalized in brilliant needles. Its taste 
is sweet, and astringent. It is liable to be decomposed by 
water containing carbonic acid, but is rodissolved by acetic 
acid. 

What are its incompatibles ? It is decomposed by all acids, 
soluble salts the acids of which produce insoluble or spa- 
ringly soluble compounds with the protoxide of lead, lime 
water, ammonia, potass?., and soda. Sulphuretted hydrogen 
gives a black precipitate, and iodide of potassium a yellow 
one. 

What are its medical properties and uses? In medicinal 
dcses it is powerfully astringent, sedative, and in large ones 
an irritant poison. 

It is administered in hemorrhages of the lungs, intestines, 
and uterus. By giving acetic acid combined with it the for- 
mation of a carbonate is prevented upon which its poison- 
ous qualities are supposed to depend. 

Dose is from 1 to 3 grains, reseated as reouired. 

What is the white load? It is the carbonate; and is only 
employed externally, being used as an application to ulcers, 
and excoriated surfaces. 1: is the most poisonous of the 
preparations of lead, producing the disease called colica pic- 
ton um. 

What is Goulard's extract of lead ? It is a solution of the 
subacetatc of lead, formed by the acetate of lead 3 xv h semi- 
vitrified oxide of lead 3^ xss » distilled water four pints, boil- 
ed, filtered, and diluted in the proportion of 3ij to a pint, 

Toxics. 

What is meant by Tonics? They are medicines which pro" 
duce gentle, and permanent excitement of the vital actions' 



148 



MATERIA MEDIC A. 



When arc tonics injurious? In the healthy state, and in 
diseases of excitement. 

They may diminish excitability, or natural healthy power; 
or, produce an irritation which may be followed by inflam- 
mation. 

Under what, circumstances are tonics indicated. In cases 
in which the vital actions are depressed below the standard 
of health. They invigorate the system in a two-fold man- 
ner; 1st. by increasing the energy of the stomach; and 2d. 
by a direct influence over the whole frame, producing an 
elevation of all the vital actions. 

How may tonics be divided? Into the pure bitters; bit- 
ters peculiar in their properties; aromatics; and mineral 
tonics. 

What are the effects of the Pure Bitters'? They increase 
the appetite, invigorate digestion, have little influence over 
the circulation, unless in large doses, and exhibit but little 
evidence of action on the nervous system. 

What are the effects of Bitters peculiar in their properties? 
They are generally more stimulating than the pure bitters. 

What are the effects of the Aromatics? They depend 
upon the presence of volatile oil, are more stimulating than 
the bitters, and approach nearer to the diffusible stimulants. 
- What are the peculiarities of the Mineral Tonics? They 
have no common peculiarity except the tonic property, each 
having peculiarities which serve to distinguish it from the 
others. 

Pure Bitters. 

From what is Quassia derived? It is the wood of the 
Quassia excelsa, and Quassia amara, trees of the West In- 
dies. 

What are the general characteristics of quassia? The 
wood is whitish, and yellowish by exposure; has a purely 
bitter taste ; the active principle is quassin. 

What are its medical properties, and uses? It has the 
properties of the simple bitters in their highest degree. It 
is particularly useful in dyspepsia from debility of the stom- 
ach. It is given in infusion in the proportion of 3ij to Oj 
cold water. Dose f3ij 3 or 4 times a day; of extract, from 
2 to 5 grains; of tincture f3j to f 3 i j . 

From what is the Gold Thread procured? It is the root 
of the Coptis trifolia. 



MATERIA MEDIC A. 



149 



What are its medical properties, and uses? It is a sim- 
ple tonic bitter, closely analagous to quassia. Dose of pow- 
der 10 to 30 grains; tincture ?3j. 

From what is Gentian procured? It is the root of the Gen- 
tiana lutea, which grows on the Alps, and other mountains; 
the active principle of which is gentianin. 

What are the general properties of the root? The taste is 
slightly sweetish, and intensely bitter. Water, and alcohol 
extract the taste, and medical virtues from It. 

What are its medical properties, and uses? It possesses 
in a higfh degree the tonic power of the simple bitters, ex- 
cites the appetite, invigorates the power of digestion, in- 
creases the temperatare of the body, and the force of the 
circulation. 

It is ofiven in powder, dose 10 to 40 grains; in infusion, 
(gss to Oj), fgi to fgij ; of tincture, f3j to f 3ij ; of extract, 5 
to 30 grains. 

What portion of the Sabbatia angularis or American Cen- 
taury is used ? The whole plant. It grows in the middle, and 
southern states in low meadows, and should be collected 
when in flower. 

What are its medical properties, and uses ? It has the ton- 
ic properties of the simple bitters. Dose of the infusion (Jj 
toOj), f3ij. 

W hat plant is the Columbo derived from I The Coculus 
palmatus. The root is the part used, and is brought from 
Africa. 

What are its general properties ? As it comes to us it is in 
flat, circular, or oval pieces, of a bitter taste, and slightly 
aromatic odor. Active principle columbin. 

What are its medical properties, and uses ? It is a useful 
mild tonic, no astringency, and but slightly stimulant. Used 
in powder, infusion, and tincture. Dose of the powder 10 
to 30 grains; of infusion (made in the proportion of gss to 
Oj) from fgj to fgij ; of tincture f3ss to fjjj. 

Bitters of peculiar, or modified properties. 

From what is the Peruvian Bark obtained? Different spe- 
cies of the Cinchona, brought from the western coast o* 
South America. 

There are three officinal varieties : 1. pale bark ; 2. yellow 
bark; and 3. red bark. 

The pale embraces the varieties called Loxa, and Lima; 



150 



MATERIA MEDICA. 



the yellow is called in commerce Callisaya bark, and of 
which there are two varieties, the quilled, and flat. 

The red is divided into the quilled, and the flat also. 
What are the active principles of bark? Quinia, and 
Cinchonia combined with kinic acid. 

What preparation of bark is generally used? The sul- 
phate of quinia. 

What are the medical properties and uses of cinchona? 
It is one of the most valuable tonics we possess; as well as 
anti-intermittent. The best mode of giving the bark is in 
substance; dose of the powder 3j. 

What is the comparative power of sulphate of quinine 
compared with the bark? 10 to 14 grams is equivalent to 
gj of good bark. It is given in intermittents in doses 
of 12 to 18 grains, in the interval of the paroxysm. As a 
mere tonic \ to i a grain 3 or 4 times a day. 

From what do wo procure the Dog wood bark? From 
the Cornus Florida, an indigenous tree. The dose and 
mode of using similar to the peruvian bark. 

What is the officinal name of the tree from which the 
Wild Cherry bark is procured? Prunus Virginiana— indi- 
genous to this country. 

What are the active principles? Hydro-cyanic acid, tannin 
and bitter extractive. 

What are its medical properties and uses? It is tonic, 
and sedative; lessens the action of the heart and arteries; 
and is useful in the hectic fever of scrofula and consump- 
tion. Dose of powder 3ss. to 3j ; of the infusion fjij 
3 or 4 times a dav. 

What is the officinal name of the Chamomile? Anthemis 
nobilis; the floweis are the parts used, although all parts of 
the plant are active. The active principle is bitter extrac- 
tive, and volatile oil. . ^ 

In small doses it is tonic, and in large ones emetic. 1 he 
cold infusion is best when used as a tonic m doses ot 1 3 1 J » 
dose of the powder 3ss. to 3j- ^ 

What are the medical properties and uses of the Eupa- 
torium perfoliatum or Thoroughwort? It is tonic, dia- 
phoretic, and taken in large doses it acts as an emetic, and 
aoerient. As a tonic it should be administered m substance 
or cold infusion. Dose of the powder 20 or 30 grains ; and 
of the infusion gi frequently repeated. As a diaphoretic 
it should be given warm. As an emetic and cathartic, n 
doses of one or two gills of the strong decoction. 



MATERIA MEDIC A. 151 

What are the medical properties and uses of the Aris- 
tolchia Serpentaria or Virginia Snake Root?- It is indigin- 
ous; the root is the part used, and its active ingredients are 
a bitter principle, and volatile oil. It is a stimulant tonic 
actinsf also as a diaphoretic, or diuretic according as it is 
administered. 

Dose of the powder 10 to 30 grains; infusion fgj to fgij 
every 2 or 3 hours; officinal tincture fgi to f 3ij • 

From what is Myrrh procured?- It is an exudation from the 
Amyris Myrrha. There are two varieties; the India and 
Turkey. 

What are its medical properties and uses? Its active 
principle is a resin and volatile oil. It is a stimulant tonic, 
with a tendency to the lungs, and also to the uterus. Em- 
ployed in diseases of these organs where there is no febrile 
excitement or acute inflammation. Used in powder and 
pill in dose of 10 to 30 grains; of the tincture f3s3. to fgj 

What are the medical properties and uses of the bark cf 
thcjGallipea officinalis, orAngustura? Its active parts are bit- 
ter extractive, and volatile oil. It is a stimulant tonic, but 
little employed in the United States. Dose of the powder 
10 to 20 grains, infusion fjij ; tincture f 3j t0 f3*j« 

False Angustura bark has poisonous properties; its active 
ingredient is brucia. 

What are the medical properties and uses of the bark of 
the Croton Elutheria, or Cascarilla? Its active ingredients 
are extractive and volatile oil. It is an aromatic tonic, and 
is now only employed where a gentle stimulant tonic is de- 
sired. Dose of the powder 20 to 30 grains; of the infu- 
sion fgij. 

Aromaiics. 

What are the general properties of aromatic tonics ? 
They owe their characteristics to volatile oils, are more 
stimulant than tonics generally; and more local in their ac- 
tion than diffusible, stimulants, relieve pains in the stomach 
and bowels, expel flatulence, &,& Decoctions and extracts 
objectionable. 

What are the medical properties and uses of Orange Pee], 
or rind of the fruit of the Citrus Aurantium? It is a mild 
tonic, stomachic, and carminative; given in infusion. 

What are the properties of the prepared bark of the Lau- 
ras Cinnamomum or Cinnamon? There are two vaaic.ics, 



MATERIA MEDIC A. 



the Ceylon cinnamon, and China cinnamon, or cassia. Its 
active principles are volatile oil and tannin; its medical use 
the same as aromatics in general, applicable in cases re- 
quiring astringents. 

Doso of powder 10 to 20 grains; tincture f3j. 
What are the properties of the bark of the Canella alba? 
Its active ingredients are volatile oil, and bitter extractive ; 
used generally combined with other articles. It is an in- 
gredient in the powder of Aloes and Canella or hiera picra. § 

From what are Cloves derived? They are the unexpand- 
ed flower buds of the Eugenia Caryophyllata or Caryophy- 
lus Aromaticus; brought from the West Indies and the Eu- 
ropean colonies of Guiana. 

What are their medical properties? Their activo princi* 
pie is a volatile oil. They are used where a stimulant aro- 
motic is indicated Dose of the powder 5 to 10 grains; 
infusion made with (3ij to Oj, Jij;) oil 2 to 5 drops; used 
in several officinal preparations. 

From what is the Nutmeg procured? It is the kernel of 
the fruit of the Myristica Moschata growing in the Mo- 
luccas. 

What are its medical properties and uses? The active 
principle is a volatile oil; it also yields a fixed oil called the 
Oil of Mace. It combines narcotic with aromatic proper- 
ties. Dose of powder 5 to 10 grains of volatile 2 or 3 drops. 

From what is *he Black Pepper obtained? It is the dried 
berries of the Piper Nigrum. 

What are its properties and uses? It contains a volatile 
oil, an acid concrete oil, and piperin. Its activity depends 
upon its oils, and not the piperin, which is inert when pure. 
It is a warm carminative stimulant, and used where such 
properties are indicated. 

From what are Cubebs obtained? It is the dried fruit of 
the Piper Cubeba a vine growing in the East Indies. 

What are its properties and uses? Its active ingredient 
is a volatile oil. 

It is aromatic, and diuretic. Dose of the powder 3 SS « to 
3iss 3 or 4 times a day; of the volatile oil 10 to 20 drops. 

From what is the Pimento obtained? The Myrtus Pi- 
mento. The active properties reside in a volatile, and fixed 
oil ; dose of the oil 3 to 6 drops. 

What are the properties and uses of Cardamom, or the 
fruit of the Alpinia Cardamomum? It is a warm aromatic 



MATERIA MEDIC A. 



153 



less heating and stimulating than some others. It enters 
into a number of officinal preparations. Dose of the com- 
pound tincture f3j. 

What other aromatic seeds are used in medicine? Fen- 
nel, Caraway, Coriander, Anise. 

What is the dose of the compound spirit of Lavender? 
The dose is f3ss. to f3j. 

What is the officinal name of the Peppermint? Mentha 
Piperita. Dose of the oil 1 to 3 drops; of the essence 10 to 
20 drops. 

What is the officinal name of the Spear Mint? Mentha 
Viridis and possesses properties similar to the last. 

What other herbaceous aromatics are used in medicine? 
The Hedeoma pulegioides, or Penny royal. Melissa officinalis 
or Balm. 

Origanum vulgare, or Origanum, and the Gaultheria pro- 
cumbens, or Partridge brrry. 

From what is Ginger procured?- It is the root of the 
Zingiber officinale, an herbaceous plant, native of the East 
Indies, and cultivated in the West Indies. 

What are its properties and uses ? It is aromatic, spicv, 
pungent, hot, and biting. Its virtues are extracted by water 
and alcohol. 

It is a grateful stimulant, and carminative ; and mav be 
given in powder, in doses of 10 to 30 grains; in infusion 
fgij ; in tincture f 3j or ±3 i j . 

In what dos:s is the Acorus Calamus or sweet flag; used? 
Its uses, modes of administration, and doses are similar to 
those of the ginger. 

Mineral Tonics. 

What are the properties of the preparations of Iron? 
They are highly tonic, raise the pulse, promote the secre- 
tions, and increase the coloring matter of the blood. The 
disease in which they are most used are chlorosis hvsteria, 
flour albus, gleet, scrofula, rickets, &c. 

What are the doses of the different preparations of Iron? 
The Filings — Ramenta ferri — in doses of 5 to 10 grains. 
Scales — Squamae ferri — 5 to 20 grains. Prepared Carbonate 
— Ferri Carbonas Praeparatus; Precipitated Carbonate — 
Ferri Carbonas Praecipitatus. Dose of the two last 5 to 20: 
grains; in neuralgic cases from 3=s to 3j 3 times a day, and 
increased. 

14 



154 



MATERIA MEDICA. 



Sulphate — Ferri sulphas — Green vitriol — Copperas — in 
doses of from 1 to 5 grains; of the dried from £ to 3 grains, 
3 or 4 times a day. 

What are the incompatibles of the sulphate"? The alka- 
lies, and alkaline carbonates, muriate of lime and baryta; 
nitrate of silver; acetate of load, tannin, &c. 

Tincture of the Muriate — Tinctura Feni Muriatus — dose 
10 to 30 minum's 3 or 4 times a day. Tartrate of Iron and 
Potassa — Ferri et Potassae Tartras — dose 10 to 30 grains. 
Phosphate 5 to 10 grains. 

What is the effect of the preparations of Copper on the 
system ? In its pure state it is inert, but in combination 
highly poisonous; in small quantities but little sensible 
effect is produced, except a slightly tonic influence* 

When taken in poisonous doses they produce a coppery 
taste in the mouth, nausea, vomiting, violent pain in the 
stomach and bowels, black and bloody stools, irregular 
pulse, faintings, thirst, difficulty of breathing, cramps, con- 
vulsions, and death. The best treatment in these cases is to 
administer white of eggs in water in large quantities. 

What are the doses of the different officinal preparations 
of Copper? Sulphate — Cupri Sulphas — Blue Vitriol. Doso 
^ of a grain 2, 3 or 4 times a day, given in pill, and omitted 
if the stomach becomes irritated. Ammoniated Copper — 
Cuprum Ammoniatum. — Dose £ a grain twice a day. 

What are the preparations of Zinc used medicinally'? The 
Sulphate, Oxide, impure Oxide, and Carbonate. 

What are the medical properties and uses of the Sulphate 
of Zinc ? It is tonic, astringent, and in large doses a prompt 
emetic. Dose as a tonic £ grain to 2 grains; as an emetic 
10 to 30 grains. 

What are the incompatibles ^ Alkalies and their carbo- 
nates, hydro-sulphates, lime water, and astringent vegetable 
infusions. 

What preparations of Bismuth are used medicinally ?- 
The Subnitrate, or White Oxide ; it is tonic, and antispas- 
modic. Doso 3 to 10 grains in powder or pill. _ 

What preparations of Silver are used medicinally? The 
Nitrate, Oxide, and Chloride. 

What are the medical properties of the Nitrate of Silver ?- 
As an internal remedy it is tonic, and antispasmodic. It 
has been employed in epilepsy, chorea, angina pectoris, &c. 
Externally it is'a vesicant, stimulant, and escharotic. Dose 



MATERIA MEDICA. 



155 



i of a grain increased to 4 or 5, three times a day in pills. 
The proper antidote for a large dose is common salt. 

What^are its incompatibles? Its incompatibles are com- 
mon salt, alkalies and their carbonates, lime water, mineral 
acids, astringent vegetable infusions, &c. 

What preparation of Sulphuric acid is used medicinally 2 
The Diluted, and the Aromatic. Dose of each 10 to 30 
drops. They increase the appetite, and promote digestion. 

What are Its incompatibles] Its incompatibles are the 
alkalies, alkaline earths, iheir carbonates, &c. 

What are the effects and dose of Nitric acid? It is tonic, 
and refrigerant when diluted; concentrated, it is a corrosive 
poison. Dose, 2 to 5 drops in water. 

What are its incompatibles] Its incompatibles are the 
alkalies, alkaline earths, their carbonates, sulphate of iron, 
the salts of lead, &c. 

What is the dose of the Nitro-Muriatic acid? From 2 to 
10 drops 3 or 4 times a day. 

Arterial Stimulants. 

What are the medical properties and usisof the Cayenne 
Pepper or Capsicum Annuum? It is a powerful stimulant, 
without being narcotic; useful in enfeebled, and languid 
stomachs; active principle capsicin. Dose of powder 5 to 
10 grs; ol infusion [3ij to Oss.] fgss; of tincture f3j to f*3ij ; 
used also as a gargle. 

What are the medical properties and uses of Spirits of 
Turpentine or Oil of Turpentine? It is stimulant, diuretic, 
anthelmintic, and in large doses cathartic. Dose, 5 to £0 
drops repeated. 

What is the dose of Phosphorus? It is 1-12 of a grain in 
oleaginous, or etherial solution. 

What are the properties, and di>se of Carbonate of Am- 
monia? It is stimulant, diaphoretic, and antispasmodic. 

The dose as a stimulant is from 5 to 10 grs., in pills, or 
emulsion, and repeated, it is one of our best stimulants in 
low fevers, &c. 

Nervous Stimulants or Antispasmodics, 

From what is Musk obtained? It is obtained from the 
Moschus Moschiferus an animal resembling the deer, found 
in Asia. 



156 



MATERIA MEDIC A, 



What are its medical properties, and uses '? It is stimu- 
lant, and antispasmodic, and used in cases where these quali- 
ties are indicated, particularly in low states of the system. 
Given in pill, and emulsion. Dose 10 grains. 

How is artificial musk prepared ? By the action of nitric 
acid on amber. 

From what is Castor obtained? It is a peculiar product 
of the Castor fiber or Beaver. It is not much used. Dose 
in substance 10 to 20 grains; in tincture fjjj to f 3ij . 

From what is Assafcetida procured? It is the inspissated 
juice of the Ferula Assafoetida. 

What are its medical properties and uses? Its active part 
is a resin, and volatile oil. It is a moderate stimulant, pow- 
erful antispasmodic, an expectorant, and feebly laxative. 
Dose 5 to 20 grains in pill, or emulsion; of the tincture f 3j . 

From what is Valerian obtained ? It is the root of the Va- 
leriana officinalis, a native of Europe. 

What are its medical properties and uses? It is a gentle 
stimulant, with a narcotic effect. It is used in hysteria, hy- 
pochondriasis, &c. Active principles a volatile oil, and vol- 
atile acid called valerianic. 

Dose of the powder 30 to 90 grains ; of the infusion (gj to 
Oj)» ' °f t ^ le rinct 111 * 6 f3j t0 f3i y ; °f the oil 4 to 6 drops. 

What are the properties and uses of the Oil of Amber ? 
It is stimulant, and antispasmodic, and used as a linament. 
Dose 5 to 10 drops in emulsion. 

What other nervous stimulants do we possess? Garlic, 
Tea, and Coffee, Skunk Cabbage, &c. 

Cesebkal Stimulants called also Narcotics from the 
stupor which they produce in large doses. 

How is Alcohol produced? By the vinous fermentation. 

What are its medical properties and uses? It is a power- 
ful stimulant, and is the intoxicating ingredient in all spir- 
ituous and vinous liquors. It is not used in medicine in a 
pure state; diluted it is extensively used as a menstruum. 

What Wines are used medicinally? Madeira, Teneriffe, 
Sherry; and Port when an astringent is indicated. 

How is Sulphuric Ether procured? By the distillation of 
alcohol and sulphuric acid. 

What are its medical properties and uses? It is a tran- 
sient, powerful, diffusible, stimulant; and given whore such 
medicines are indicated. Dose f3ssto f3j. 



MATERIA MEDIC A. 



157 



From what is Opium obtained? It is the concrete juice 
of the PapavCr somniferum 

Of what is it composed ? Morphia, narcotina, codeia, me- 
conic acid, gum, extractive, resin, &c. 

What are its incompatibles? All vegetable infusions 
containing tannin, and the alkalies. 

What are its medical properties and uses? It is a stimu- 
lant narcotic. It diminishes the peristaltic action of tho 
bowels, and all the secretions except of the skin; allays 
inordinate muscular contractions, and general nervous irri- 
tation. Medium dose in substance is 1 grain: of the tinc- 
ture 25 drops; of the camphorated tincture f3i, fgj of 
which contains 2 grains of opium; of the acetated tincture 
20 drops wmich is equal to 1 grain of opium; of the sul- 
phate, acetate and muriate of morphia 1-6 of a grain is equal 
to 1 grain of opium. 

From what is Lactucarium procured'? It is the inspissated 
milky juice of the Lactuca sativa. Dose 2 to 3 grains. 

From what is Henbane procured ? From the Hyosciamus 
Niger. Leaves and seeds, officinal. 

What are its properties and uses ? Its active principle is 
hyosciamin or hyosciamia. It is narcotic in] large doses; in 
6mall ones it gently accelerates the circulation, and increases 
the general warmth; it does not constipate. 

Dose of leaves 5 to 10 grains; of extract which is mostly 
used 2 or 3 grains; of tincture f3j. 

From what are Hops procured? They are the strobiles of 
the Humulus Lupulus. 

The active principles are a volatile oil, and a peculiar bit- 
ter principle. 

What is Lupulin? It is a yellowish powder obtained 
separate by rubbing and sifting the strobiles. Its bitter 
principle is called lupulite or lupuline. 

What are their medical properties and uses? Tonic, 
moderately narcotic, and used in diseases of debility where 
morbid vigilance exists. 

Dose of the infusion of hops (made with gss to Oj of 
water) is,*fgij; of the tincture f3i to f^ss, of the lupulin 
6 to 12 grs in piil; of the tincture f3j to f 3ij. 

From what is Camphor derived? From the Laurus Cam- 
phora, an evergreen growing in China and Japan. It is pro- 
cured by sublimation from the roots and smaller branches. 

What are its properties and uses? It is verv volatile, and 
14* 



158 



MATERIA MEDIC A. 



may be sublimed unchanged. The medium dose is 5 to 10 
grs. in emulsion. It enters into the composition of several 
linaments. 

What is the active principle of Atropa Belladonna or 
Deadly Nightshade ? An alkaline principle called atropia. 

The leaves of the plant are the part used. Dose of the 
powdered leaves 1 gr. night and morning; of the infusion 
(B] to gx of water) fgj to fgij ; of the extract, which is the 
inspissated juice \ to i a grain twice a day, and increased if 
necessary. It is used in the form of plaster, and as an appli- 
cation to the eye, and the os uteri. 

What part of the Datura Stramonium or Thorn Apple is 
used medicinally? The leaves, and the seeds. The active 
alkaline principle is daturia. 

What are its medical properties and uses? It is a power- 
ful narcotic, and sometimes used in epilepsy. Dose of tho 
seeds 1 gr; of extract from seeds \ to \ a grain; of the pow- 
dered leaves 2 to 3 grs; of the extract of the leaves 1 gr, 
Used also as an ointment. 

What is the dose of the Dulcamara or Bittersweet? Of 
the officinal decoction fgij, 4 times a day; of extract 5 to 10 
grs. Active principle solania. 

What is the dose of the Conium maculatum or Hemlock ? 
Of the pow T dered leaves 3 or 4 grs; >>f the extract or inspissa- 
ted juice of the leaves 3 grs. 

Arterial Sedatives. 

What preparations of Antimony are employed medici- 
nally? The tartar emetic, precipitated sulphuret, and anti- 
monial powder. 

What are the properties and uses of Tartar Emetic or the 
Tartrate of Antimony and Potassa 1 ? It is the most impor- 
tant of the antimonials. Its general action is sedative on 
the circulation, while it excites many of the secretions. It 
may produce An alterative, diaphoretic, diuretic, expecto- 
rant, purgative, and emetic effect, according as it is admin- 
istered. Applied externally it acts os a counter irritant. 

Its dose as an alterative is from 1-32 to 1-12 of a grain; as 
a diaphoretic, or expectorant from 1-12 to 1-6 of a grain ; as 
a nauseating sudorific from i to £ gr. repeated as occasion 
requires ; as a puigative 1-6 of a grain combined with Epsom 
salts 3j, and repeated every two or three hours; as an emet- 
ic from 2 to 4 grains given in divided portions at intervals of 
10 or 15 minutes. 



MATERIA MEDIC A. 



159 



The antimonial wine contains 2 ers. of tartar emetic to 

f 3.i- 

What are its incompatibles ? Mineral acids, the alkalies 
and their carbonates, sulphurets, lime water, and vegetable 
astringents. 

What is the dose of the Precipitated Sulphuret? As an 
alterative 1 to 2 grs; as an emeto-cathartic 5 to 20 giain<. 

What is the dose of the Antimonial Powder used in imi- 
tation of James' powder? From 3 to 8 grains. 

What othei medicines are used as arterial sedatives? 
Nearly all the neutral alkaline salts, and those in which th 
acid predominates ; they are usually called refrigerants, the 
most prominent of which is nitrate of potassa. Dose 5 to 10 
grains every hour or two, in powder or solution. It is fre- 
quently combined with tartar emetic. 

The Vegetable acids are also refrigerant or arterial seda- 
tives. 

Nervous Sedatives. 

To what class of diseases are nervous sedatives applica- 
ble? To complaints attended with nervous disorder, and 
unhealthy excitement of the heart and arteries. 

What are the medicinal properties and uses of the leaves 
of the Digitalis purpurea or Foxglove? It is narcotic, seda- 
tive, and diuretic. 

It is best given in substance. Dose 1 grain twice or three 
times a day; of the officinal infusion f^ss; of the tincture 
10 drops, which is equivalent to 1 gr. uf the substaace. It 
requires caution in its exhibition. 

In what preparations is the Hydrocyanic or Prussic acid 
found ? In the Cherry Laurel water, and in the Oil of Bit- 
ter Almonds. 

What are its properties and uses? It is a deadly poison; 
one or two drops of the pure acid is sufficient to prove fatal. 
The medicinal article is diluted, and may be given in doses 
of from 1 to 6, or 8 drops in distilled water, gum water, or 
syrup. It should be administered with caution, commenc- 
ing with the smallest dose. The antidotes are chlorine, am- 
monia, cold affusion, and artificial respiration. 

What is the active principle of the Nicotian a tabacum or 
Tobacco? Nicotia. 

What is the quantity given as an injection! Infusion, 
made of 3ss to Oss at a time. 



MATERIA MEDIC A. 



Emetics. 

What are emetics? Medicines capable of producing 
vomiting in certain doses, and as an ordinary result. 

What are the therapeutical effects of emetics'? Evacua- 
tion of the stomach, mechanical pressure on the abdominal 
viscera, reduction of arJerial action during the period of 
nausea, muscular relaxation, promotion of the secretory 
functions of the skin, liver, and lungs, powerful agitation of 
the whole frame, purgation frequently, revulsion to the sto- 
mach, depletion, and irritation of the stomach. 

What are the circumstances contra-indicating the use of 
emetics? Acute inflammation of the stomach, bowels, or 
neighboring viscera; strong sanguineous determination to 
the brain; and pregnancy in the advanced stages. Caution 
should also be observed in cases of hernia. 

From what is Ipecacuanha obtained? It is the root of the 
Cephselis Ipecacuanha, growing in South America. 

What are its properties and uses? In large doses it is 
emetic; in smaller, diaphoretic, and expectorant; in still 
smaller, stimulant to the stomach promoting its healthy ac- 
tions. Its active principle is emetia. It is mild, and cer- 
tain in its operation Dose as an emetic 15 to 30 grains; as 
a nauseant 2 to 3 grains; as a diaphoretic, £ to 2 grains; as 
an alterative, h gr. repeated 2, 3, or 4 times a day. 

The Wine of Ipecacuanha is emetic in doses of fjj to an 
adult, and f3j to an infant. 

What is the dose of the root of the Gillenia trifoliata In- 
dian physic or American Ipecacuanha? From 20 to 30 grs. 

What are the properties and uses of the Lobelia inflata or 
Indian Tobacco? Besides emetic, diaphoretic, and expec- 
torant properties it has narcotic properties. The whole plant 
i3 active. It bears a close resemblance in its effects to to- 
bacco. It is too powerful and distressing as well as hazar- 
dous in its operation for ordinary use. Dose of the powder 
from 5 to 20 grs. as an emetic; of the tiaccure f3j to f3ij 
every two or three hours until it acts. 

What other vegetable substances possess the property of 
producing vomiting, and are occasionally used for that 
purpose ? The root of the Euphorbia Ipecacuanha in 
doses of from 10 to 15 grains. 

The root of the Sanguinaria Canadensis; active ingredi- 
ent sanguinarina. Dose of the powder from 10 to 20 grains; 
©f the tincture f3iij to gss. 



MATERIA MEDIC A. 



161 



The Squill; in dose of 6 or 8 grains, 
Tobacco; dose of the powder 5 or 6 grains. 
Mustard in powder; dose gj. 

What is the character of Tartar Emetic as an emetic? It 
is characterized by certainty, strength, and permanency, 
of operation. It remains in the stomach longer than ipe- 
cacuanha, and exerts a more powerful impression on the 
system generally. 

Dose 2 to 4 grains given in divided portions; 1 grain with 
10 of ipecac repeated if necessary, makes a good emetic; 
of the wine fgss to fgi repeated if neeessary; for a child 
1 or 2 years old, 20 to 40 drops. 

"What are the characteristics of the Sulphate of Zinc as 
an emetic? It is charactetized by promptness and com- 
paratively little nausea. Used chiefly as a mere evacuant 
of the stomach in cases requiring a prompt and energetic 
emetic; as in narcotic poisons, when it should be combined 
with ipecacuanha. Dose 10 grains to 3ss. 

What are the characteristics of the Sulphate of Copper as 
an emetic? It is characterized by promptness, and slight 
nausea more prompt and powerful than the last article. Sel- 
dom used except in narcotic poisoning where it is given in 
doses of 5 to 15 grains, 

Cathartics. 

What are Cathartics? They are medicines which pro 
duce evacuations from the bowels. They operate; ]. by 
irritating the mucous membrane of the bowels; 2. by stim- 
ulating the exhalent vessels and mucous follicles; and 3. by 
stimulating the liver. Some act one way, and some another, 
and some by a combined action. 

Do they operate on all parts of the alimentary canal alike? 
No : some operate on one portion, and some on another, and 
others on the whole. 

What is meant by a hydra ofoguo cathartic? A cathartic 
which produces large watery evacuations. 

How are cathartics divided? Into laxatives, purges, and 
drastics or drastic purges. 

In what way are cathartics useful in disease? They 
evacuate the bowels and relieve constipation; they directly 
deplete from the blood vessels; promote absorption; act as 
revulsives; and some by increasing the secretions from the 
liver, and thereby relieving congestion. 



162 



MATERIA MEDICA. 



Is the action ^of cathartics modified by combination? It 
is; by mixing several drastics together they become milder 
without loss of purgative power. Small doses of emetic 
substances promote their operation; the same effect is also 
produced by bitters. Their tendency to gripe may be less- 
ened by aromatics. 

Vegetable Cathartics. 

From what is Manna procured] It is the concrete juice 
of the Fraxinus Ornis growing in the south of Europe. 
There are three varieties: flake, common, and fat manna 

What are its medical properties and uses? It is a gentle 
laxative. Dose gj to gij, Active principle mannite. 

What are the properties and uses of the Cassia Fistula or 
Purging Cassia? The pulp of the pods is the medicinal 
portion. It is gently laxative, and given in cases of habitual 
costiveness. It is an ingredient in the confection of senna. 

Dose gss to gj. 

What plant produces the Castor Oil? The Ricinus Com- 
munis, a native of Africa but cultivated in Europe and. in 
this country. The oil is obtained from the seeds by ex- 
pression. 

What are its medical properties and uses? It is a mild 
cathartic, speedy in its action, and good to remove ac- 
cumulation of feces in the boweb. 

Dose for an adult f gj ; children require more in proportion 
than adults. 

From what is Rhubarb obtained? It is the root of differ- 
ent species of Rheum; of which we get three varieties, the 
Russian, Chinese, and European, The Chinese is the most 
used, but the Russian is the best. The active principles are 
rhubarbarin and tannin. 

What are its medical properties and uses? It combines 
a cathartic and astringent power; it is tonic and stomachic 
in small doses; roasting increases its astringent, and de- 
creases its purgative effects. Dose as a stomachic and lax- 
ative 5 to 10 grains ; of the European variety the dose should 
be double. There are numerous officinal preparations of 
rhubarb. 

From what is Senna obtained? It is the leaves sf sev- 
eral species of Cassia. There are three commercial varie- 
ties — Alexandria, Tripoli and India Senna. 

What are its properties and uses? It is a prompt efficient 
and safe purgative, 



MATERIA MEDIC A, 



163 



Its active'principle is cathartin. Dose of the powder 3j; 
generally given in infusion, which is officinal and given in 
doses f 3ii every 4 or 5 hours. The elixir salutis is a tinc- 
ture of Senna and Jalap. Dose f 3ij to fgss- 

Dose of Confection oi Senna 3j to gss. 

What is the properties and dose of the Cassia Marylan- 
d 4 ca or American Senna? It is similar in properties to 
senna, but weaker ; dose £ greater. 

What are the properties and uses of the extract of the 
Juglans cinerea? It is a mild cathartic, operating without 
pain, and evacuating the alimentary canal without debili- 
tating. 

Dose 20 to 30 grains as a purgative, and 10 or 12 grains as 
a laxative. 

From what is Aloes procured? It is the inspissated juice 
of different species of Aloe. 

There are three commercial varieties, Cape, Socotorine, 
and Hepatic Aloes. 

What are its properties and uses? It is cathartic, opera 
ting slowly, but certainly, and has a peculiar affinity for the 
large intestines. 

It also lias a tendency to the uterine system. Dose as a 
laxative from 2 to 6 grains; as a purgative 10 to 15 grains. 
It is usually given in pill. There is a largo number of offi- 
cinal preparations of aloes. 

From what is Jalap obtained? It is the root of the Ipo- 
mea Jalapa, a vine, native of Mexico. 

What are its properties and uses? It is an active cathar- 
tic, operating briskly, and sometimes with pain, producing 
copious watery stools. 

Dose of the powder 15 to 30 grains; of the resin of jalap 
8 to 10 grains; of the extract 10 to 20 grains. 

What are the properties and uses of the Podophyllum 
peltatum? It is an active, certain cathartic, produces 
copious liquid discharges without much griping, or other 
unpleasant effect. It resembles jalap in its operation, and 
is applicable whenever a brisk cathartic is required. The 
dose of the powdered root is about 20 grains. 

From what is Scammony obtained? It is the inspissated 
juice of the Convolvulus Scammonia, growing in Siberia 
and Asia Minor. There are two varieties in commerce, the 
Aleppo and Smyrna Scammony. 

What are the medical properties and uses of scammony ? 



164 



MATERIA MEDIC A. 



It is an energetic cathartic, apt to occasion griping, and may 
be used in cases where a powerful impression is desired. It 
is seldom given alone. Dose 5 to 10 grains. 

What are the properties and uses of the root of the Helle- 
bonis niger or Black Hellebore? It is a drastic h) T dragogue 
cathartic with emmenagogue powers; the fresh root applied 
to the skin will inflame and vesicate. Dose 10 to 20 grains. 

It is seldom given alone. 

"What is Colocynth procured from 1 ? It is the fruit of the 
Cucumus Colocynthus deprived of its rind. It is an annual 
plant bearing considerable resemblance to the common cu- 
cumber; and is a native of Turkey. 

What are its medical properties and uses?- The pulp is a 
powerful, drastic, hydragogue cathartic, producing all the 
effects of cathartics of this class. The dose is 5 to 10 grains. 
The active principle is colocynthin. It is seldom given alone. 
The most common form of its exhibition is the compound 
extract, which is officinal. Dcse 10 to 15 grains. 

W 7 hat is Gamboge? It is the inspissated juice of a tree 
supposed to be Stalagmatis Cambogioides or Garcinea Cam- 
bogia, natives of Asia. 

What are its. properties and uses? It is a powerful, dras- 
tic, hydragogue cathartic ; apt to nauseate, and vomit, and 
used in cases where such properties are indicated. Dose 3 
to -6 grains in pill or emulsion. It is a constituent in tho 
compound cathartic pill, the dose of which is 3 pills 

What is Elaterium produced from ? The Momordica Ela- 
terium or squirting cucumber, a native of Europe. The 
fruit has the shape of a small oval cucumber, about 1£ 
inches long, covered with stiff hair, or prickles. The elate- 
rium is the substance spontaneously deposited by the juice 
oi the fruit, resides in that part which surrounds the seeds, 
and may be obtained without expression. 

What are its properties and uses? It is a powerful hydra- 
gogue cathartic, and in large doses will excite vomiting. 

The dose of ordinary commercial elaterium is from 1 to 2 
grains given in i grain portions, repeated every half hour, or 
hour until it operates. Of the purest 1-8 of a grain is a dose. 
The active principle is elaterin. Dose 1-16 oi a grain. 

What is the Croton Oil procured from? It is the oil of the 
seeda of the Crotm Tiglium, a native of the East Indies; 
obtained by expression of the seeds after having been de- 
prived of their shell. 



MATERIA MEDIC A. 



165 



What are its properties and uses? It is a powerful, hy- 
dragogue purgative, producing violent effects if given in an 
over dose. 

Dose 1 or 2 drops, administered in pill with a crumb of 
bread. Applied externally it inflames the skin, and pro- 
duces a pustular eruption. 

Mineral Cathartics. 

What are the properties and uses of Flowers of Sulphur? 
It is laxative, diaphoretic, and alterative, is evidently ab- 
sorbed, and passes off by the skin. Dose as a laxative 3j to 
3ij. It is used externally as an ointment, and in vapor. 

How is Lac Sulphuris prepared ? By boiling sulphur and 
lime in water, filtering, precipitating by muriatic acid, and 
washing the precipitate. 

What are the properties and uses of the Carbonate of 
Magnesia? It is antacid, and by combining with acid in 
the stomach becomes cathartic. Dose 3ss to 3ij. 

What are the properties of Calcined Magnesia, or 
Magnesia usta? It is antacid, and laxative; used very 
much among children. Dose for an adult 3j, for a child 2 
years old from 10 to 20 grains. 

Saline Cathartics. 

What is the general character of saline cathartics? They 
are intermediate in power between laxatives, and purges, 
produce watery evacuations; operate a3 arterial sedatives, 
and do not act harshly. These properties adapt them to in- 
flammatory and active febrile complaints. They closely 
resemble each other in properties. 

W T hat are their doses? Sulphate of Soda or Glauber's 
salt; of the crystalized salt gj to gij ; effloresced, half the 
quantity. 

Sulphate of Magnesia or Epsom salts; dose gj to gjss. 

Sulphate of Potassa; dose gss to gjss. 

Supertartrate of Potassa, called also cream of tartar; dose 
gss to gj. It is frequently combined with jalap as a hydra- 
gogue. 

Tartrate of Potassa or soluble tartar. Dose gss to gj. 

Tartrate of Potassa and Soda or Rochelle salt. Dose gj to 
gjss. It enters into the compcsition of the Seidlitz Powders, 
which are tartrate of potasssa and soda 3ij, and bi-carbonato 
of soda £ij in a white paper; and tartaric" acid grs. xxxv in a 
blue paper. 
15 



166 



MATERIA MEDICA. 



Phosphate of Soda. Dose gj to gij. 

What is the officinal name of Calomel? Mild Chloride 
of Mercury — Hydrargyrum Chloridum Mite, sometimes im- 
properly called Submuriato of Mercury. 

What are the tests of purity? It sublimes freely on the 
application of heat, and strikes a black color free from red- 
dish tinge, by the action of fixed alkalies. The presence of 
corrosive sublimate may be tested by ammonia. 

What are its incompatibles? The alkalies, alkaline earths 
and their carbonates, hydrosulphates, &c. 

Howard's calomel is prepared by bringing steam in con- 
tact with it while in a state of vapor, which converts it into 
an impalpable powder, and washes it from corrosive subli- 
mate. 

What are the medical properties and uses of calomel? 
In addition to the general properties of mercurials, it unites 
those of a purgative, and anthelmintic. 

It is employed to a great extent, and is the most valuable 
of the mercurial preparations. 

As a cathartic its tendency to increase the secretory func- 
tions of the liver is its chief value. 

As an alterative the dose is £ a gr. every other night, or 
every night, keeping the bowels at the same time gently 
open; to produce salivation the dose is h to 1 gr. 3 or 4 times 
a day increased if necessary; if it purges it should be com- 
bined with opium; as a purgative the dose is 5 to 15 or 20 
grs. Larger doses are required in proportion for children 
than adults. 

Calomel is frequently combined with other purgatives. 
Diuretics. 

What are Diuretics'? They are medicines which increase 
the secretion of urine. 

How do they operate? In one or more of three ways: — 
by entering the circulation; by a sympathetic impression; or 
by promoting absorption. 

From what is the Squill obtained? It is the bulb of the 
Scilla maratima, growing on the borders of the Mediterrane- 
an. Its active principle is called scillitin. 

What are its medical properties and uses? It is diuretic, 
expectorant, and in large doses emetic, and purgative. As 
a diuretic it is generally combined with calomel, and used 
when there is not much inflammatory action existing. Dose 



MATERIA MEDICA. 



167 



as a diuretic, or expectorant 1 to 2 grains repeated 2 or 3 
times a day, and increased in quantity until its action is 
evinced. As an emetic from 6 to 12 grains. 

What are the properties and uses of the bulb and seeds of 
the Colchicum autumnale or Meadow Saffron'? They pro- 
duce sedative effects upon the nervous system as well as 
stimulate the secretions. Given in sufficient doses they pro- 
duce disorder of the stomach and bowels, vomiting and pur- 
ging severely. When not carried off by the bowels, diuresis 
and diaphoresis are produced. They are used in rheumatism, 
and gout. Dose of the bulb, or seeds, from 2 to 8 grains; 
but it is usually administered in the form of wine. 

There are two officinal vinous tinctures. 

The Vinum Colchici Radicis, the dose of which is from 
10 drops to f3j. 

The Vinum Colchici Seminis. Dose f3ss to f3j. 

What aTe the properties and uses of the root of the Apo- 
cynum Cannabinum or Indian Hemp? It is diuretic, pow- 
erfully emetic, and cathartic. 

Used in decoction, made with gss to Ojss of water, and 
boiled to Oj ; dose of which is fgj to fgij 2 or 3 times a day. 

What are the properties and uses of the Leontodon Tar- 
axicum or Dandelion? It is slightly diuretic, tonic, and ape- 
rient; and is thought to have a specific action on the liver. 
Its properties adapt it to diseases of the digestive organs, 
and dropsical affections depending upon them. An irrita- 
ble condition of the stomach, and bowels, and acute inflam- 
mation contra-indicate its use. Dose of the officinal decoc- 
tion fgij 2 or 3 times a day; of the extract 20 or 30 grs. 

What are the properties and uses of the fruit of the Juni- 
perus communis or Juniper berries? The active ingredient 
is a volatile oil. 

The berries are stimulant, and diuretic, and in large doses 
produce irritation of the urinary passages ; they are general- 
ly used as an adjuvant to more powerful diuretics. It is a 
native of Europe. Dose of the infusion, (gj to Oj) one pint 
during the day, often combined with cream of tartar. Dose 
of the oil 5 to 15 drops. 

What are the properties and uses of the seeds of theDau- 
cus Carota or Wild Carrot?- They are gently stimulant, 
and diuretic, and may be used in nephritic affections where 
the stomach is enfeebled. The active ingredient is a vola- 
tile oil. Dose 3ss to 3j of the bruised seeds, or one pint of 
the infusion, made with gjss to Oj of water, in the 24 hours, 



3» 



168 MATERIA MEDICA. 

What are the properties and uses of the root of the Apium 
Petroselinum or Parsley? It is diuretic, and aperient; used 
in stranguary. Dose of the infusion indefinite, 

From what is turpentine obtained? It is the juice of dif- 
ferent species of the genera Pinus, Abies, and Larix, and 
consists of a resin, and volatile oil. 

There are two kinds used in the United States. The 
common white turpentine, derived principally from the 
Pinus palustris ; and the Canada turpentine, derived from the 
Abies balsamifera or Balsam of fir. Their virtues reside in 
the volatile oil. 

What are their medical properties and uses? They are 
stimulant, diuretic, anthelmintic, and laxative. If long 
continued they produce irritation of the mucous membrane of 
the urinary organs. Dose 10 grains to 3j? i n pill or emulsion. 

The volatile oil or spirit of turpentine is generally used; 
the dose of which is 10 to 20 drops, and repeated. It is also 
used externally as a rubefacient. 

What is the Balsam of Copaiva derived from? It is the 
the juice of the Copaifera officinalis, and other species of 
the Copaifera, growing in Brazil and Guiana. 

What are its properties and uses? Its constituents are a 
resin and a volatile oil? It is gently stimulant, diuretic 
and laxative. 

It is used in gonorrhoea, leucorrhoea, gleet, chronic dys- 
entery, and in chronic bronchitis. 

Dose 10 to 30 drops 3 times a day; of the volatile oil 5 to 
15 drops. 

What are the medical properties and uses of Cantharis 
vesicatoria, Cantharides, or Spanish Flies? Administered 
nternally they are powerfully stimulant, and exercise a pe- 
culiar influence over the urinary organs. In moderate doses 
diuretic* Externally applied they inflame and vesicate. — 
Dose 1 or 2 grains of the powder 2 or 3 time daily; of the 
tincture 10 drops as often. 

What are the doses of the Carbonates of Potassa? The car- 
bonate is used in doses of 10 to 30 grains 3 or 4 times a day. 

The bicarbonate is used in doses from 3ss to. 3j. 

What are the medical properties and uses of the Acetate 
of Potassa, or sal diureticus. It is diuretic in .doses of from 
9j to 3j, overy 2 or 3 hours. In large doses it is cathartic. 

What are the properties of Bitartrate of Potassa, or Cream 
of Tartar, It is diuretic, cathartic, and refrigerant. In 



MATERIA MEDICAL 



169 



small doses it is a cooling aperient; in large ones it is a 
hydragogue cathartic, which renders it useful in dropsies? 
as well as on account of its diuretic properties, 

The dose is from 3j to 3ij as an aperient; and from gss 
to gj as a hydragogue cathartic. 

What are the medical properties and uses of the Nitrate 
of Potassa or Saltpetre? It is diuretic, refrigerant, and dia- 
phoretic. 

Dose as a diuretic from 10 to 20 grains repeated. 

What are the medical properties and uses of Spirit of 
Nitric Ether, or Sweet Spirit of Nitre? It is diuretic, dia- 
phoretic, and anti-spasmodic. 

Dose in febrile diseases as a diaphoretic about one tea- 
spoonful. 

When given as a diuretic it should be given in larger 
doses. 

Diaphoretics. 

What are Diaphoretics ? They are medicines which pro- 
mote perspiration. 

How do they exert a beneficial effect in disease? By re- 
moving constriction of the cutaneous capillaries; by deple- 
ting from the blood vessels; by revulsion to the surface; by 
promoting absorption, and by eleminating noxious matter 
from the blood. 

What circumstances should a patient be subjected to if 
free perspiration be required? He should be confined 
bed, well covered, clothed with flannel next the skin, and 
warm diluent drinks freely given. If there is high inflam- 
matory excitement the lancet or other depleting remedies 
should be premised. 

How are diaphoretics divided? Into nauseating, refrig 
ant, and alterative diaphoretics. 

Nauseating Diaphoretics, 

What are some of the nauseating diaphoretics, 
cacuanha, and Tartrate of Antimony and Potassa. 

With what is ipecacuanha usually 'combined? With 
opium in the form of Dover's Powders, which consists of 
ipecacuanha 1 grain, opium 1 grain, and sulphate of potassa 
8 grains. Dose 10 grains repeated every 4 or 6 hours. 

What is the dose of tartar emetic as a diaphoretic ? From 
1-12 to i of a grain. 
15* 



170 



MATERIA MEDIC A. 



Refrigerant Diaphoretics. 

What are some of the refrigorant diaphoretics) Citrate 
of Potassa, Acetate of Ammonia, Nitrate of Potassa, and 
Spirit of Nitric Ether. 

How is the Citrate of Potassa used? In two forms; the 
neutral mixture or saline draught and the effervescing 
draught. Dose of the former f^ss every hour or two. Of 
the latter f^ss of me alkaline solution with fgss of the 
lemon juice or the acid solution. 

They are sometimes combined with tartar emetic; and 
also with spirits of nitre. 

How is the Acetate of Ammonia used? In the form of 
the officinal solution called liquor ammonia acetatis, oi 
spiritus Mindereri. Dose fgss to fgj repeated every 2 or 3 
hours. 

How is Nitrate of Potassa used? It is usually com- 
bined with tartar emetic, 1-6 gr. to 10 or 15 grains of the 
nitrate. 

How is the Spirit of Nitre used? It is used in fevers 
where there is nervous derangements, or a typhoid tendency 
and in children. 1 

Dose 20 drops to f3j repeated. 

Alterative Diaphoretics. 

What are some of the alterative diaphoretics? The pro- 
ducts of the Guaiacum officinale, Mezereon, Sassafras, and 
Sarsaparilla 

What are the products of the Guaiacum officinale. The 
Guaiacum wood, and the Guaiac a concrete juice. The 
medicinal properties of Jho wood are owing to the guaiac 
which it contains. It grows in the West Indies and South 
America. 

What are the properties and use of guaiac. It is stimu- 
lant, alterative, and promotes the secretions particularly of 
the skin. Dose of powder 10 to 30 grains with sweetened 
water or mucilage. There are two officinal tinctures. Dose 
of either f 3 j . The wood is used in decoction, and is an 
ingredient in the compound decoction of sarsaparilla. 

From what is Mezereon obtained? It is the bark of the 
root of different species oi Daphne; a native of Europe. 

What are its properties and uses? The recent bark ap- 
plied to the skin inflames and vesicates. Given internally 



MATERIA MEDIC A. 



171 



it is stimulant, which may bo directed to the skin or kidneys. 
Dose of the bark in substance 10 grains. Generally given 
in decoction with licorice root, which is officinal. Dose a 
tea cup-full four times a day. 

"What are the officinal portions of the Lauras Sassafras ? 
The bark of the root, (Sassafras Radicis Cortex) and the 
pith of the twigs (Sassafras Medulla). 

What are the medical properties and uses of the bark 1 It 
is stimulant, and diaphoretic. Its active principle is a vola- 
tile oil, dose from 2 to 10 drops. The infusion may be given 
ad libitum. 

What are tho properties and uses of Sarsaparilla ? It is 
the root of different species of the smilax growing in Mex- 
ico, West Indies, and South America. Its active principle is 
sarsaparillin. It acts upon the secretions, and thereby pro- 
duces alterative effects. There are numerous officinal pre 
parations. Dose of the powder 3ss. 3j. ; of the compound 
decoction fg iv. — of the syrup gss; — of the alcoholic 
extract 10 to 20 grains; of the fluid extract f3j. 

ExFECTOKAXTS. 

What are Expectorants ? They are medicines which in- 
crease the secretion from the mucous membrane of the air 
cells, and air passages of the lungs; or facilitate its discharge. 

What circumstances should a patient be subjected to while 
using expectorants ? The surface should be kept warm, and 
flannel worn next to the skin. 

Are emetic substances usually expectorant in small doses? 
Yes, ipecacuanha in doses of 1 to 2 grains; a tartar emetic 
in doses of i of a grain: and their preparations also in this 
proportion. 

What are the properties and uses of Squill as an expecto- 
rant? It stimulates the vessels of the lungs; and where 
there is much inflammation it should be preceded by blood- 
letting. The officinal preparations are the vinegar, syrup, 
oxymel, and tincture. 

Dose of vinegar f3ss. to f 3j, of syrup and oxymel from 
f3j t0 f3\j- °f tincture from 20 to 40 drops. 

What are the properties and uses of the bulb of the Alli- 
um Sativum or Garlic ? It is a general stimulant and pro- 
motes expectoration in debilitated states of the lungs. The 
expressed juice is often given to children with sugar. Dose 
f3ss. to 3j. 

What are the properties and uses of the roof of the Pdly- 
gala Senega orSeneka? Its active principle is senegirx, 



172 



MATERIA MEDIC A. 



It is a stimulating expectorant, and diuretic; it also acts 
more or less on all the secretions. 

Dose of powder from 10 to 20 grains; of decoction made 
by boiling gj of the root with gj of liquorice root in Ojss of 
water to Oj ; given in doses of fgj to fgjj 3 or 4 times a day. 
It is an ingredient in Coxe's hive syrup. 

What are the properties and uses of the root of the Cimi- 
cifuga racernosa or black snake root? It stimulates the se- 
cretions and particularly those of the skin, kidneys, and 
bronchial mucous membrane. 

Dose of powder 10 to 30 grains; decoction fgj to fgij, re- 
peated frequently. 

From what is Ammoniac obtained] It is the inspissated 
juice of the Dorema Ammoniacum, an umbelliferous plant 
growing in Persia. It comes in tears and masses. 

What are its properties and uses? It is a stimulant, and 
expectorant gum resin; mostly used in chronic catarrh, asth- 
ma, and other pectoral diseases. Dose 10 to 30 grains in 
emulsion or pill. 

What is the character of Assafcetida as an expectorant? 
It is an efficient expectorant, and moderate stimulant. Dose 
5 to 15 or 20 grains, in pill or emulsion. 

From what is the Balsam of Tolu obtained? The My- 
roxolon Toluiferum? a tree growing in Tropical America.— 
Its essential constituents are a resin, volatile oil, and ben- 
zoic acid. It is procured by incising the trunk of the tree, 
and collecting t..c juice. 

W'hat are its medical properties and uses? It is a gently 
stimulating expectorant. 

Dose 10 to 30 grains in emulsion; of the tincture f3j 
to f3ij. 

What are the properties and uses of the balsam of the 
Myroxylon Peruiferum, or Peruvian balsam? Its constitu- 
ents are a resin, volatile oil, and benzoic acid. It is a warm, 
stimulating tonic, and expectorant. Doso f3ss. 

Emmenagogues. 

What are Emmenagogues? They are medicines which 
promote the menstrual secretion. 

How do emmenagogues act? They may act either 
through the medium of the circulation; or by an impression 
being made elsewhere, and extended sympathetically to the 
utorine vessels. 



MATERIA MEDIC A, 



173 



How should they be given so as to produce their full 
effect? A short time before the regular period of menstru- 
ation. The sfate of the system should be carefully con- 
sidered; if the system is plethoric they should be preceded 
by depletion, and the milder ones of the class should be 
used. If debility exist those of a tonic or stimulant char- 
acter should be used; and if constipation attend, the ca- 
thartic emmenagogues are indicated. 

What are the properties of the calybeates as regards their 
emmenagogue power? They are considered to be inferior 
to no other remedies in this respect, and are applicable 
where there is no local inflammation or general excitement. 
They are often combined with aloes. 

What are the properties of Aloes as an emmenagogue? 
It is very effective, and believed to exert a specific influence 
on the uterine vessels independent of its cathartic property. 
Dose 1 or 2 grains 2 or 3 times a day. It may also be given 
in enema about the period when menstruation should come 
on. 

What is the dose of Black Hellebore as an emmenagogue? 
From f3ss to f3i of the tincture, 2 or 3 times a day. 

What are the properties of Guaiac as an emmenagogue? 
It is applicable in cases associated with rheumatism, partic- 
ularly in its neuralgic forms. Used in dysmenorrhoea either 
in the simple or ammoniated tincture. Dose f3j 3 or 4 times 
a day. 

What are the properties of the loaves of the Juniperus 
Sabina or Savine? They are highly stimulant, increase 
most of the secretions, and particularly those of the uterus. 

The active principle is a volatile oil called oil of Savine. 
It should bo avoided in pregnancy. Dose of the powder 
from 5 to 20 grains, 2 or 3 times a day; of the oil from 2 to 
5 drops. The plant is a native of Europe. 

What are the properties of Cantharides as an emmena- 
gogue? They exert a powerful stimulant effect over the 
urinary and genital organs. 

Dose of the tincture 10 to 30 drops three times a day. 

Epispastics. 

What are Epispastics? Medicines that produce a blister 
when applied to the skin. They are called also vesicatories. 

How do they exert a remedial influence? By acting indi- 
rectly as general stimulants; by their revulsive action; by 



174 



MATERIA ME DIG A. 



substituting their own action for a diseased oncjjin the part 
to which they are applied; by their local stimulus; by pru- 
ducing local depletion; by the pain they occasion which 
may be useful in hypochrondrical cases; and they are em- 
ployed to separate the cuticle for the purpose of applying 
medicines. 

What aro the officinal preparations of the Cantharis vesi- 
catoria or Spanish Fly as an epispastic? The Cerate of 
Spanish flies commonly called blistering plaster. Used for 
blistering. 

The Ointment used for maintaining a discharge. 

The Plaster of Pitch with Spanish flies. Used as a rube- 
facient plaster. 

The Linamcnt of Spanish flies generally called decoc- 
tion of flies in oil of turpentine. Used as an external stim- 
ulant. 

What are the remedies for stranguary produced by can- 
thai ides? The milder diuretics such as uva ursi, sweet 
spirit of nitre, mucilages, &c. 

Where are they procured? In Spain and Italy. Active 
principle cantliaradin. 

What aro the properties of the indigenous insect the Can- 
tharis Vittata or Pottato fly? They are'similar to the Span- 
ish flies; the chemical composition and uses the same. 

Rubefacients. 

What are Rubefacients? They are medicines which in 
flame the skin, and producing redness without ordinarily 
vesicating. 

What are the indications for the use of this class in pre- 
ference to blisters? In cases where a sudden and powerful 
action is necessary ; and in cases whoro a slight but Jong 
continued action is desired; in which case the milder arti- 
cles should be employed. 

Will you enumerate tho rubefacients commonly employ, 
ed? The seeds of the Sinapis alba and S. nigra, distin- 
guished as white and black mustajd; Cayenne Pepper; Oil 
of Turpentine; Burgundy Pitch which is the product of tho 
Abies Communis, growing in the north of Europe; Hem- 
lock Pitch or Pix Canadensis, very analagous to the Bur- 
gundy pitch; and Aqua Ammonia which is much used in 
combination with sweet oil as volatile liniment, 



MATERIA MEDICA. 



175 



• ESCHAROTICS. 

What are Escharotics ? They are substances which de- 
stroy the life of the part to which they are applied, andpro= 
duce sloughing. They operate by chemical agency, or by 
influencing the vitality of the part directly. 

What substances are used for this purpose? The Actual 
cautery; Moxa; Potassa or common caustic; Nitrate of Sil- 
ver; or Lunar caustic; Arsenious acid ^or the white oxide; 
Sulphate of Copper; Bichloride of Mercury or Corrosive sub- 
limate; Burnt Alum, and the Mineral acids. 

Demulcents. 

What are Demulcents ? They are bland substances which 
form a viscid solution with water. 

What medicines are used as demulcents? Gum Arabic, 
the product of several species of the Acacia. Tragacanth, 
Slippery Elm bark or the inner bark of the Ulmus fulva. 
Flax seed or the seeds of the Linum usitatissimum. 

Licorice root or the root of the Glycyrrhiza glabra. Ice- 
land moss or Lichen Islandicus. Irish moss or Carrageen. 
Sago, the product of the Sagus Rumphii. Tapioca, the pro- 
duct of the Jatropa Manihot of Tropical America. Arrow 
root, the product of the Maranta arundinacea of the "West 
Indies. And the Barley, called commonly pearl barley or 
hordoum perlatum. 

Emollients. 

What are Emollients? They are substances which re- 
tain moisture, and form a soft mass without irritating prop- 
erties. 

Diluents. 

What are Diluents? They are liquids which dilute the 
contents of the stomach, and bowels, fill the bloodvessels, 
and increase and dilute the secretions. Water is the great 
diluent, to which additions are made to give it flavor. 

Medicines Unclassified. 

From what is Ergot obtained? It is a product of the Se 
cale cereaie or common rye. 

WTiat are its properties and uses? It yields its virtues to 
water, and alcohol. Its active principle is crgotin, It exhi- 



176 



MATERIA MEDIGA. 



bits a strong tendency to the uterus, and operates with ener- 
gy upon its contractile property ; and reduces the frequency 
of the pulse. Bread made from rye contaminated with it, 
and long used will produce dry gangrene, typhus fever, dis- 
eases of the nervous system, &c. 

It is adapted to lingering cases of labor where the os ute- 
ri is dilated, the external parts relaxed, and no mechanical 
impediment exists; the delay being ascribable solely to a 
want of energy in the uterus. 

Dose of the powder 10 to 20 grains; of the infusion gj, 
made with 3j of the ergot to fgiv of water, to be repeated 
every 20 minutes until its peculiar effects are produced. 

From what is the Nux Vomica obtained? It is the seed 
of the Strychnos Nux Vomica, a tree growing in the East 
Indies. The active ingredients are strychnia and brucia. 

What are its properties and uses? In very small doses 
it is tonic, and operates upon the secretions. In larger doses 
so as to produce a decided effect, its action is chiefly direct- 
ed to the nerves of motion producing a tendency to perma- 
nent, involuntary, muscuJar contraction. It is sometimes 
used in paralytic affections, and its action appears to be par- 
ticularly directed to the parts affected. Dose of the powder 
5 grains; of the alcoholic extract from 1-2 to 2 grains; of 
strychnia from 1-12 to 1-6 of a grain. 

What are the properties and uses of Arsenious acid? In- 
ternally it is alterative, febrifuge, and peculiarly applicable 
in diseases of a periodical character. The effects should be 
carefully noted, and when there is any disposition to edsema 
produced, especially of the face, and eyelids, or a feeling of 
stiffness, tenderness of the mouth, &c, it should be discon- 
tinued immediately. It has been used in scirrhus, anomal- 
ous ulcers, intermittent fever, diseases of the bones, and in 
cutaneous diseases. It is an ingredient in nearly all empiri- 
cal, external remedies for cancer. 

Dose 1-12 of a gr. in pill, and taken 3 times a day. Of the 
Fowler's solution 10 drops 2 or 3 times a day. 

What are the preparations of Mercury that are used me- 
dicinally, and their doses as alteratives, or sialagogues? 
Mercurial ointment or Unguentum Hydrargyri; Mercurial 
Plaster or Emplastrum Hydrargyri — Mercurial Pills or Pilu- 
lae Hydrargyri commonly called blue pills. Dose 1 pill 3 
times a day as asialagogue; 1 every night or every other 
night as alterative. The officinal pill weighs 3 grains, and 



MATERIA MEDIC A. 



177 



contains 1 gr. of mercury i Mercury with chalk or Hydrar- 
gyrum cum Creta, dose 5 to 20 grains twice daily. 

Black oxide of mercury or Hydrargyri Oxidum Nigrum — 
dose 1 to 3 grains 2 or 3 times a day — Red oxide of mercury 
or Hydrargyri Oxidum Rubrum, commonly called red preci- 
pitate; used externally as an escharotic, and stimulant — -the 
officinal ointment called Unguentum Hydrargyri Oxidi Ru- 
bri — Mild chloride of mercury or Hydrargyri Chloridurn mi- 
te commonly called Calomel; dose from 1-2 a gr. to 1 grain 
3 times daily— Corrosive chloride of mercury or Hydrargyri 
Chloridurn Corrosivum commonly called corrosive subli- 
mate; dose from 1-8 to 1-4 of a grain 3 or 4 times a day — 
Yellow sulphate of mercury or Hydrargyri Sulphas Flavus, 
commonly called Turpeth mineral, dose as an alterative 
from 1-2 grain to 1 grain, and from 2 to 5 grs. as an emetic; 
seldom used; sometimes as an errhine, diluted with 5 parts 
of starch — Ammoniated mercury or Hydrargyrum Ammoni- 
atum, commonly called white precipitate ; used externally 
Nitrate of mercury, used only as an ointment, called the 
ointment of nitrate of mercury or Unguentum Hydrargyrum 
Nitratis commonly called citrine ointment — Red Sulphuret 
of mercury, or Hydrargyri Sulphuretum Rubrum commonly 
called cinnabar, used only for fumigation — Black sulphuret 
of mercury or Hydrargyri Sulphuretum Nigrum, formerly 
called Ethiops mineral, scarcely ever used at present. 

"What are the properties and uses of Iodine?- It operates 
as a general excitant, but particularly of the glandular, and 
absorbent systems. 

If long continued or given in very large doses it gives 
rise to derangement of the nervous system, restlessness^pal- 
pitation, a sense of burning along the gullet, excessive 
thirst, acute pain in the stomach, violent cramps, rapid and 
great emaciation, and frequent pulse. The condition of the 
system in which any of these poisonous effects are exhibit- 
ed are called iodisni. It is used in glandular enlargements 
and morbid growths. Dose j to £ of a grain 3 times a day. 
It is never used in powder but dissolved in alcohol or a wa- 
tery solution of the iodide of potassium. Dose of the offi- 
cinal tincture 10 to 20 drops. 

The Iodide of Potassium is officinal. Dose 1 to 2 grains; 
Lugols solution is iodine Bj, iodide of potassium gij and 
water 3vii. Dose 6 drops repeated. Iodine ointment, gj of 
lard and 9j of iodine. 
16 



178 



MATERIA MEDIC A. 



Antacides. 

What are Antacids'? Substances capable of combining 
with and neutralizing acids. 

What substances are used as antacids?- The carbonates 
of potassa and soda, ammonia, lime, and magnesia. 

Anthelmintics. 

What are Anthelmintics? Substances which operate on 
worms in the alimentary canal, and render them easy of 
expulsion. 

From what is Pink root obtained] It is the root of the 
Spigelia Marylandica, and is the only part of the plant which 
is officinal. 

What are its properties and uses? It is considered to be 
one of the most powerful of the anthelmintics. In over 
doses it determines to the brain giving rise to vertigo, dim- 
ness of vision, spasms, &c. Dose of the powder for a child 
from 2 to 4 years old, 10 to 20 grains, repeated twice a day, 
and followed by a cathartic; sometimes it is combined with 
calomel. Dose of the infusion for a child fgss to fgj, 3 or 
4 times a day, made with gss of the root to Oj. of water; 
often given with gss of senna added, in the same dose. 

What are the properties of the bark of the root of the 
Melia Azedarach, or Pride of China'? Used in decoction 
made by boiling Oji of water with giv of the fresh root to 
Oj. Dose for a child gss every 2 or 3 hours, and followed by 
a cathartic. 

From what is Worm seed obtained? They are the seeds 
of the Chenepodium anthelminticum. 

What is the dose? In substance bruised Qj to £ij for a 
child; of the volatile oil from 4 to 8 drops for a child, re- 
peated twice a day. 

What are the properties and uses of Cowhage? The spi- 
culae are vermifuge, and act mechanically on the worm. 
Dose of the electuary for an adult gss; for a child 3 or 4 
years old 3f. 

What is the dose of the oil of turpentine as an anthel 
mintic? For an adult from fjss to fgij or even more fol- 
lowed with castor oil. Dose for children in proportion. 

What is the dose of Stannum or Tin as an anthelmintic? 
From 3j to gj. 



MATERIA MEDICA. 



179 



TABLE OF SIGNS AND ABBREVIATIONS. 



H 

aa 

m 

3 
3 

e 

o 
C3 

f3 

«l 

Chart. 

Coch. 

Collyr; 

Cong. 

Decoc 

Ft. 

Garg. 

Gr. 

Gtt. 

Haust. 

Infus. 

M. 

Mass. 

Mist. 

Pil. 

Pulv. 

Q. S. 

3. 

Ss, 



Recipe. 
Ana. 

Libra vel librae. 
Uncia vel unciae. 
Drachma vel drachmae. 
Scrupulus vel scrupuli. 
Octarius vel octarii. 
Fluiduncia vel fluidunciae. 

Fluidrachma vel fluidrach- 
mae. 

Minimum vel minima. 

Chartula vel chartulae. 

Cochlear vel cochlearia. 

Collyrium. 

Congius vel Congii. 

Decoctum. 

Fiat. 

Gargarysma. 

Granum vel gran a. 

Gutta vel guttae. 

Haustus. 

Infusum. 

Misce. 

Massa. 

Mistura. 

Pilula vel pilulae. 
Pulvis vel pulveres. 
Quantum sufficit, 
Signa. 
Semis, 



Take. 
Of each. 

A pound or pounds. 
An ounce or ounces. 
A drachm or drachms. 
A scruple or scruples. 
A pint or pints. 
A fluidounce or rluidoun- 
ces 

A fluidrachm or fluid 

drachms. 
A minim or minims. 
A small paper or papers. 
A spoonful or spoonfulls. 
An eye -water. 
A gallon or gallons. , 
A decoction. 
Make. 
A gargle. 
A grain or grains. 
A drop, or drops. 
A draught. 
An infusion. 
Mix. 
A mass. 
A mixture, 
A pill or pills. 
A powder or powders, 
A sufficient quantity. 
Write. 
A half, 



J 80 



MATERIA MEDIC A, 



Examples of Common Extemporaneous Prescriptions. 



Powders. 
R Antimonii et Potass® Tar- 
tratis gr. i. 
Pulveris Ipecacuanhas gi. 
Fiat pulvis. 
S. To be taken in a wine- 
glassful of sweetened i 
water. 
An active emetic, 
R Hydrargyri Chloridi Mi- 
tis, 

Pulveris Jalaps, aa gr. x. 
Misce. 

S. To be taken in syrup, or 
molasses. 
An excellent cathartic in 
the commencement of 
bilious fevers, and in 
hepatic congestion. 
R Pulveris Jalapae gr. x. 
Potassae Bitartratis 3^* 
Misce. 

S. To be taken in syrup, or 
molasses. 
A hydragogue cathartic 
used in dropsy and scro- 
fulous inflammation of 
r the joints. 
R Sulphuris 

Potassae Bitartratis gii. 
Misce. 

S. To be taken in syrup, or 
molasses. 
A laxative, used in piles 
and cutaneous diseases. 
R Pulveris Rhei gr. x. 
Magnesiae 3ss. 
Fiat pulvis. 
S. To be taken in syrup, or 
molasses. 
A laxxative and antacid, 



used in diarrhoea, dys- 
pepsia, &c. 
R Pulveris Scillae gr. xii. 
Potassae Nitratis 3i 
Fiat pulvis, in chartulas 
sex dividendus. 
S. One to be taken twice or 
three times a day in syr- 
up or molasses. 
A diuretic, employed in 
dropsy. 
R Potassae Nitratis 3i. 

Antimonii et Potassae Tar- 

tratis gr. i. 
Hydrargyri Chlorid. Mi- 

tis gr. vi. 
Fiat pulvis, in chartulas 
sex dividendus. 
S. One to be taken every two 
hours in syrup or molas- 
ses. 

A refrigerant, diaphoretic, 
and alterative, used in 
bilious fevers; usually 
called nitrous powders. 
R Pulveris Guaiaci Resinae* 
Potassae Nitratis, aa 3 1 * 
Pulveris Ipecac, gr. iii. 
Opii gr. ii. 

Fiat pulvis, in chartulas 
sex dividendus. 
S. One to be taken every 
three hours in syrup or 
molasses. 
A stimulant diaphoretic, 
used in rheumatism and 
gout after sufficient de- 
pletion. 

Ferri Subcarbonatis. 
Pulveris Colombae, 
R Pulveris Zingiberis, aa. 31 



MATERIA MEDICA. 



181 



Fiat pulvis, in chartulas 
sex dividendus, 
S, One to be taken three times R 
a day in syrup or molas- 
ses. 

A tonic, used in dyspepsia 
and general debility. I 
Pills. 

R Pulveris Aloes, S. 
Pulveris Rhei, aa 3 SS * j 
Saponis 9i. 

Misce, et cum aqua fiat' 
massa in pilulas viginti: 
dividenda. 
S. Two or three to be taken R 
daily, at bed-time, or be- 
fore a meal. 
An excellent laxative in 
habitual costipation. 
R Massae Pilularum Hydrar-| 

Pulveris Aloes, S, 

Pulveris Rhei, aa 9i. 

Misce, et cum aqua fiat; 
massa in pilulas viginti! 
dividenda. 
S. Three to be taken at bed- 
time. 

An alterative and laxative,' R 
useful in constipation 1 
with deranged or defi-j 
cient hepatic secretion, j 
R Pulveris Aloes, 

Extracti Quassias, aa. gi. 

Olei Ansi Tt[x. 

Syrupi, q. s. 

Misce, et fiat massa in |S. 
pilulas triorinta dividen- 
5a. 

S. Two to be taken once, 
twice, or three times a 
day. 

A laxative, tonic, and car R 
16* 



urinative, useful in dys- 
pepsia. 

Pulv. Rhei. 

Sapo Alba. 

Myrrhae. 

Assafaetida 3 SS 

Misce, et fiat massa in pi- 
lulas triginta dividenda. 

One or two to be taken af- 
ter each meal. 

Useful in promoting diges- 
tion, and relieving pain 
and uneasiness of the 
stomach. 

Pulveris Scillae Qh 

Hydrargyri Chloridi Mitis 
gr. x. 

Polveris Acacia?, 

Syrupi, aa q. s. 

Misce, et fiat massa in pil- 
ulas decern dividenda. 

One to be taken two or 
three times a day. 

A diuretic and alterative, 
much used in dropsy, es- 
pecially when complica- 
ted with organic viscer- 
al disease. 

Pulveris Opii gr. iv. 

Pulveris Ipecacuanhas gr. 
xviii. 

Pulveris Acaciae, 

Syrupi, aa q. s. 

Misce, et fiat massa in pi- 
lulas duodecim dividen- 
da. 

One to be taken after each 
stool. 

An anodyne diaphoretic, 
useful in dysentery and 
diarrhoea after the use of 
laxatives. 

Pulveris Opii, 



182 



MATERIA MEDIC A. 



Pulveris Ipecacuanha, aa 
gr. Hi. 

Hydrargyri Caloridi Mitis 
gr. vi. 

Pulveris Acaciae, 

Syrupi, aa q. s. 

Misce, et fiat mass a in 
pilulas tres dividenda. 
S. Ono or more to be taken 
at bed-time, or accord- 
ing to circumstances. 

An anodyne, diaphoretic, 
and alterative, very use- 
ful in diarrhaea, dysen 
tery, typhoid pneumonia 
and various other disea- 
ses. 

R Plumbi Acetatis in pul- 
verem triti gr. xii. 

Pulveris Opii gr. i. 

Pulv. Acacias, 

Syrupi, aa q, s. ut fiat mas 
sa in pilulas sex dividen 
da. 

S. One every two, three, or 
four hours. 
An astringent much em 
ployed in haemoptysis 
and uterine hemorrhage 
Mixtures. 
R Magnesiae 3i. 
Syrupi fji. 

Tere simul, et affunde 
Aquae Acidi Carbonici fg 
iv. 

Fiat haustus. 
S. To be taken at a draught, 
the mixtute being well 
shaken. 
An agreeable mode of ad- 
ministering magnesia. 
R Mannae gi. 

Fceniculi contusi 31. 



Aquae bullientis fjiv. 
Fiat infusum et cola; dein 
adjice 

Magnesias Carbonatis 3H. 

Ft. Mist. 
S. One third to be taken eve- 
ry three or four hours 
till it operates, the mix? 
ture being shaken. 

An excellent carminative 
and mild laxative in flat- 
ulence and pain in the 
bowels, 
R Olei Ricini fgi. 

Pulveris Acacia?, 

Sacchari, aa 3H. 

Aquae Menthae Piperitae 

Acaciam et saccharum 
cum ftuiduncia dimidia 
aquae menthae tere; de- 
in oleum adjice, et con- 
tere; denique aquam re- 
liquam paulatim infun- 
de, et omnia misce. 
S. To be taken at a draught, 
the mixture being well 
shaken. 
R Olei Ricini fji. t 
Vitellum ovi unius. 
Tere simul, et adde 
Syrupi fgss. 
Aquae Menthae Pipertae fgii 
Ft. haust. 
S. To be taken at a draught, 
the mixture being well 
shaken. 
This and the preceding 
formula afford conveni 
ent modes of adminis- 
tering castor oil, when 
the stomach is irritable. 
Any other fixed oil may 



MATERIA MEDICA. 



183 



be given in the same 
way. 

R Olei Ricini fgiss. 

Tincturae Opii gxxx. 

Pulv. Acacias, 

Sacchari, aa gii. 

Aquae Menthae Viridis fjiv 

Acaciam et saccharum 
cum paululo aquae men- 
thae tere; dein oleum ad- 
jice, etiterum tere; den- 
ique aquam reliquam 
paulatim infunde, et om- 
nia misce. 
S. A tablespoonful to be ta- 
ken every hour or two 
hours till it operates, the 
mixture being each time 
well shaken. 

Used as a gentle laxative 
in dysentery and diar- 
rhoea. It is usually 
known by the name ol 
oleaginous mixture* 
R Elaterii gr. i. 

Spiritus JEtheris Niirici 
fgii. 

Tincturae Scillee, 

Oxymellis Colchici, aaf3ss 

Syrupi, fgi. 

Ft. mist. 
S. A teaspoonful to be taken; 
three or four times a day 
in a little water. 

Diurectic, used in Ferriar 
dropsy. 
R Copaitae, 

Spiritus Lavandulae Comp. 
aa f3ii. 

Mucilaginis Acaciao f3ss. 

Syrupi f3iii. 

Simul tere ; dein paulatim 

■affundo. 



Aquae fgiv. 
Misce. 

S A tablespoonful to be ta- 
ken four times a day or 
more frequently. 
Given in chronic catarrhs, 
and chronic nephritic af- 
fections. The dose must 
be larger in gonorrhce. 
Neutral M xture. 
R Acidi Citrici 3ii. 
Olei Limonis 7T[i. 
Simul tere et adde 
Aquae fjiv. 
Liqua, et adde 
Potassae Carbonatis q. s, 

ad saturand. 
Misce et per lintcum cola. 
Or" 

R Succi Limonis recentis 

Potassae Carbonatis q. 8. 

ad saturandum. 
Misce et cola. 
S. A tablespoonful to be giv- 
en with an equal quan- 
tity of water every hour 
or two hours. 
An excellent diaphoretic 

in fever. 
Effervescing Draught. 
;R Potassse Carbonatis 3^- 
Aqee igiv. 
Liqua. 

Or 

R Potassee Bicarbonatis 3iii, 
Aquae fgiv. 
Aquee fgiv. 
Liqua. 

S. Add a tablespoonful of the 
solution to the same 
quantity of lemon or 
lime juice, previously 



MATERIA MEDIC A. 



mixed with a tablespoon 
ful of water; and give 
the mixture, in a state, 
of effervescenco, every 
hour or two hours. 
An excellent diaphoretic 
and anti-emetic in fever 
with nausea or vomiting. 
Brown Mixture. 
R Pulv. Extract, Glycyrrhi- 
zas. 

Pulv. Acaciee 311. 

Aquae ferventis fjiv. 

Liqua, et adde 

Vini antimonii f3ii. 

Tincturae Opii tt|xx. 

Ft. Mist. 
S. A tablespoonful to be ta- 
ken occasionally. 

Expectorant, demulcent, 
and anodyne, useful in 
catarrhal affections. 
R Antimonii et Potassas Tar 
tratis gr. as, 

Syrupi Scillr, 

Liquoris Morphias Sulpha- 
tis, aa fjss. 

Pulveris Acacias gii. 

Syrupi fgss. 

Aquae fluvialis fjiv. 

Ft. Mist. 
S. A tablespoonful to be ta- 
ken occasionally. 

An expectorant and ano- 
dyne cough mixture. 
R Acidi Nitrosi f3i. 

Tincturae Opii gtt. xl. 

Aquae Camphorae fgviii. 

Misce. 

S. One-fourth to be taken ev- 
ery three or four hours. 
Hope's mixture, used in 
dysentery, diarrhoea, and 
cholera. 



R Camphorae 3*« 
Myrrhae 3ss, 
Pulv. Acaciae, 
Sacchari, aa 3^- 
Aquae fjvi. 

Camphoram cum alcoholis 
paululo in pulverem to- 
re; dein cum myrrha, 
acacia, et saccharo con- 
tere; denique cum aqua 
paulatim instillata mi- 
sce. 

S. A tablespoonful to be ta- 
ken for a dose, the mix- 
ture being well shaken. 

A convenient form for ad- 
ministering camphor. 
R Cretae prcparata £iv. 

Massae Pil, Hydrarg. 
gr. viii. 

Tincturae Opii. gtt. viii. 

Pulveris Acacoe, 

Sacchari, aa 3i« 

Aquas Cinnamomi, 

Aquas, aa 13. 

Solida simul tere, dein li- 
quida paulatim inter te- 
rendum adjice, et omnia 
misce. 

A teaspoonful to be taken 
for a dose, the mixture 
being well shaken. 
An antacid and alterative 
mixture, well adapted to 
infantile diarrhoea with 
white stools. The dose 
mentioned is for a child 
a year or two old, and 
may be repeated four or 
six times in twenty-four 
hours. 
R Pulveris Kino 3ii. 
Aquas bullientis f3vi. 



MATERIA MEDIC A. 



185 



Fiat infusum et cola; dein 
secundum ariem ad-: 
misce. 

Cretae praeparatae 3iii. R 

Tincturae Opii f3ss. 

Spiritus Lavandulae com- 
positi fjss. 

Pulveris Acaciae, 

Sacchari, aa 3'ti. 
S. A tablespoonful to be ta- 
ken for a dose, the mix- S. 
turo being well shaken. 

Astringent and antacid, 
useful in diarrhoea. 
Solutions. 
R Magnesias Sulphatis oz. i. 

Syrupi Limonis fgi. R 

Aquae Acidi Carbonici 
fgvi. 

Misce. 

S. To be taken at a draught. 
An agreeable mode of ad- 
ministering sulphate of 
magnesia. S. 
R Potassae Nitratis 31. 

Antimonii et Potassae Tar- 
tratis gr. i. 
Aquae fluvialis fgiv. 
Liqua. R 
S. A tablespoonful to be ta- 
ken every two hours. 
A refrigerant diaphoretic, 
used in fevers. 
R Magnesia Sulphatis ozi. 
Antimonii et Potassae Tar- S. 

tratis gr. i. 
Succi Limonis recentis 

fgi. . 

Aquae fgiii. 
Misce. 

S. A tablespoonful to be ta- 
ken every two hours tilljfi 

I 



it operates upon the 

bowels. 
Useful in fevers. 
Quiniee Sulphatis gr. xii. 
Acidi Sulphurici Aromati- 

ci Tfjxx. 
Svrupi fgss. 

Aquae Mentha3 Piperitae 
Misce. 

A teaspoonful to be taken 
every hour or two hours. 

A good mode of adminis- 
tering sulphate of qui- 
nia in solution. 
Ixfusicxs. 

Sennae 3iii. 

Magnesia Sulphatis, 

Mannae, aa gss. 

Fceniculi 3*« 

Aquae bullientis Oss. 

Mac era per horam in vase 
leviter clauso et cola. 

Give a teacupful every 
three or four hours till 
it operates. 

An excellent purgative in 
febrile complaints. 

Colombae contusae, 

Zingiberis contusi, aa. Jss. 

Sennae 3H. 

Aquae bullientis Oi. 

Macera per horam in vase 
leviter clauso et cola. 

A wineglassful to be taken 
morning, noon and even- 
ing, or less frequently if 
it operate too much. 

An excellent remedy in 
dyspepsia with coned- 
pation and flatulence. 

Spigeliae %$s, 

Sennae 3'ii, 



180 



MATERIA MEDICA. 



Mannao oz, i. 

Fceniculi 311. 

Aquae bullientis 01. 

Macera per horam in vase 
leviter clauso et cola. 
S. A wineglassful to be giv- 
en to a child from two 
to four years old, three 
or four times a day. 

A powerful anthelmintic. 
R Pulveris Cinchonse Ru- 
br93 oz. i. 



Acidi Sulphurici Aromati- 

ci f3i. 
Aquse Oi. 

Macera per horas duode- 
cim, subinde agitans. 
S. A wineglassful of the 
clear liquid to be taken 
for a dose. 

A good method of admin- 
istering Peruvian bark 
in cold infusion. 



APOTHECARIES' WEIGHT, U. S., Lond., Ed., Dub. 

Pound. Ounces. Drachms. Scruples. grains, 
ifc 1 = 12 == 96 = 288 = 5760 
3 1= 8 = 24 = 480 
3 1 = 3 = 60 
9 1 = gr. 20 

APOTHECARIES' OR WINE MEASURE. U. S. % Dub. 

Gall. Pints. Fluidounc's. Fluidr'ms. Minims. Cubic In, 
Cong 1 = 8 = 128 = 1024 =s 61440 = 231 

O 1 =* 16 = 128 R 7680 = 28-875 
f 3 1 ss 8 p= 480 = 1-8047 

f3 1 == 111 60 = -2256 



PART IV.— SURGERY. 



Inflammation. 

What are the symptoms of inflammation? Unusual red 
ness, heat, swelling and pain, 

How has inflammation been divided) Into acute, chronic, 
healthy, and unhealthy. 

How many stages are there of inflammation? Two; tho 
cold and the hot. In tho first there is coldness, languor, 
nausea, and a small quick pulse. In tho second the skin is 
hot, pulse full and hard, there is thirst, and the part be- 
comes swelled and painful. It is not however always ac- 
companied by constitutional symptoms. 

What are the terminations of inflammation? There are 
eight, resolution, adhesion, effusion, suppuration, ulceration, 
granulation, cicatrization, and mortification, which consti- 
tute a series of stages. 

What are the causes of inflammation? They are chem- 
ical, and mechanical. Among the former are excessive heat, 
cold, cold and moisture combined, atmospheric air, noxious 
gasses, acids, alkalies, blisters, rubefacients, animal poisons, 
contagious, and specific diseases. Among the latter are con- 
tusions, lacerations, punctures, fractures, luxatious, pressure, 
and numerous other agents. 

Is every part of the body subject to inflammation? Yes; 
but in an unequal degree ; the liability is generally in pro- 
portion to the sensibility of the part. 

How are the means of arresting inflammation divided? 
Into constitutional and local. Among the former are blood- 
letting, purgatives, diaphoretics, and low diet; among the 
latter are topical blood-letting, blistering, cold, acetate of 
lead, tincture ot iodine, nitrate of silver, rest, and position- 



188 



SURGERY, 



Suppurative Inflammation. 

What are the symptoms of suppuration? The redness 
assumes a brighter hue, the swelling increases, becomes 
pointed, and softer, pain is increased, and there is a sensa- 
tion of pulsation, and throbbing. Rigors or shivering often 
occurs, and are looked upon as a sure indication that pus is 
formed, or about to be. 

When the pus is once formed pain and redness diminish, 
the swelling fluctuates, and a cavity exists which encloses 
the matter. 

What are the characteristics of healthy pus? It is of a 
light yellow or cream color; made up of small globules 
which float in a watery fluid. 

Unhealthy pus is called ichor when it is thin and acrid. 
Sauies, when it is a foetid ichor mixed with blood. Sordes 
when it is of a leaden color, thick, and offensive. Malignant, 
when generated in pestilential diseases. Contagious, when 
it has the power of producing a disease of the same charac- 
ter. 

What is the treatment of suppurative inflammation?- If 
the patient has been much enfeebled by evacuations, we 
substitute a better regimen, employ tonics, mineral acids, 
and opium. As local means we use fomentations, and 
warm poultices. Poultices should be continued after the 
discharge of matter unless it is kept up too profusely when 
other mild dressings should be employed. 

What rules should govern us in regard to opening abces- 
ses? Abcesses situated on the face, near large cavities, or 
joints should be opened early. In other cases they may be 
left longer. The best instrument for opening them is a nar- 
row sharp pointed history; which should be passed in slow- 
ly until you find by the feel that it is in the sack, then cut 
forward so as to make a free incision. 

Ulcerativ e Inflammat ig n . 

What is meant by ulcerative inflammation or ulcerative 
absorption? It is that morbid process by which the conti- 
nuity of the different textures of the body is destroyed. 

What parts of the body are liable to ulceration? Every 
texture is liable ; but the skin and mucous membranes suf- 
fer more readily than other parts. Pain always attends this 
process and it is generally lancinating. 



SURGERY, 



Mortification. 

What U mortification * Gangrene is that condition which 
immediately precedes the destruction of a part. Sphacelus 
denotes the complete death of apart; and the term mortifi- 
cation designates both stages of the complaint. 

What are the different kinds of gangrene? They are the 
wet and dry; and the idiopathic and traumatic. 

The idiopathic is constitutional, and the traumatic results 
from an inj ury. 

What are the causes of mortification I It is generally the 
result of inflammation. It may be caused also by poisons, a 
deficient supply of arterial blood, any cause which will en- 
feeble the circulation, deposites in the arteries, Ergot, &c. 

What are the symptoms ? The part loses its sensibility, 
.heat, and color. These changes seldom take place sudden 
ly, but arc preceded by an increase of pain, and swelling ; the 
blood circulates only in the larger vessels ; ihe skin become 
soft and of a dark red or purple color, and vesicles contains 
ing a thin serum are formed under the cuticle. When it is 
complete, if you press upon the part the blood will not re- 
turn. Along with these symptoms the pulse becomes quick 
and tremulous, of a typhoid character, tongue dry and 
brownish, skin hot, the patient restless, uneasy, and fre- 
quently with delirium, subsultus, nausea, and hiccup. 

What is the treatment? When there is high inflamma- 
tion which is likely to terminate in gangrene, the antiphlo- 
gistic treatment should be adopted; but if gangrene has ta- 
ken place a different practice must be pursued. The bowels 
should be gently opened, and tonics, and nutritious food 
given. Opium, carbonate of ammonia, camphor, &c, will 
be found beneficial. Local remedies are of use only where 
the mortification is incomplete; when scarifications, emoli- 
ent poultices, blisters, &,c. have been recommended. In Se- 
nile gangrene opium is an important remedy. T> prevent 
sloughing or bed sores, from long confinement, the parts 
when they are first discolored should be washed with a so- 
lution of nitrate of silver 10 gr. to gj of water 3 or 4 times a 
day, then cover with bland adhesive plaster. The hydrosta, 
tic bed is highly recommended by Dr. Musscv as a preven 
titive. Where the sores have formed, dress with adhesive" 
plaster, and change the position of the patient. 

Amputation is seldom resorted to in cases of mortification 
17 



190 



SURGERY. 



before a line of separation is formed, although it is some- 
times, in traumatic gangrene ; but it should never be in the 
idiopathic variety. 

What are the symptoms of dry mortification? The toes 
and feet lose their heat, and .become shrivelled, discolored 
and converted into a hard, dry, insensible mass, of a dark blue 
or black color, without previous swelling, redness, pain, or 
fetoj. 

What is the treatment? Amputation. 

Erysipelas, 

What are the symptoms of erysipelas? The [surface of 
the part affected is elevated, varies from a bright scarlet to a 
purplish color, has an abrupt termination, and is accompa- 
nied with a burning, or itching sensation. There is general- 
ly more or less rigor, fever, nausea, &c. preceding the com- 
plaint, The symptoms are sometimes slight, and sometimes 
very severe, particularly in the epidemic form, and when it 
attacks the head and face. 

What are the causes of erysipelas? The causes are not 
always obvious; in other cases it may be traced to the ap- 
plication of poisons, wounds, exposure, derangement of the 
digestive organs, &c. 

What is the treatment? In the commencement if indi- 
cated by the general symptoms, recourse should be had to 
blood-letting, purgatives, diaphoretics and low diet. Some- 
times a contrary plan becomes necessary during the course 
of the disease, and opium, baik, camphor, &c, may be in- 
dicated. The local remedies in use are tincture of iodine 
nitrate of silver and acetate of lead in solution, incis- 
ions, mercural ointment, British oil, starch, flour, &c. The 
nitrate of silver applied with a pencil so as to surround the 
inflammation is frequently resorted to. 

Furunculus or Boil* 

What are the symptoms of furunculus? It is a hard' 
painful, and highly inflammed tumor, conical, base below 1 
and apex above thejlevel of the skin; and contains a disor- 
ganized mass called a core. 

What is the treatment? Encourage suppuration with 
warm poultices, and as soon as the apex becomes soft make 
an opening into it large enough to remove the core. 



SURGERY 



191 



Anthrax or Carbuncle 

What are the symptons of anthrax 1 ? It is a deep seated 
circumscribed, hard, and painful swelling, of a livid hue, 
attended with itching and a burning heat, and terminates 
by slouching. The constitutional symptons are often very 
severe, particularly loss ol appetite, fever, prostration, &c. 
When on the scalp they nearly always prove fatal. 

What is the treatment? Emmollient poultices in the first 
stage until vesications, or a discharge of bloody serum ap- 
pears; it should then be freely covered with caustic vege- 
table alkali, as recommended by Dr. Physick. Other sur- 
geons recommend that it should be opened early by free in- 
cisions, and stimulating applications used. Opium should 
be freely employed to assuage pain, and procure sleep 

Pernio or Chilblain. 

What are the symptoms of perino? It is the resu of 
cold, and is met with in the extreme parts of the body. At 
first the skin is pale and shrivelled, which is succeeded by 
redness, tumefaction, pain, pruritus, and cedema. In severe 
cases the skin becomes purplish, the itching very violent, 
vesication takes place arid forms an ill conditioned sore. — 
The mild form frequently disappears in summer, and returns 
in the winter. 

What is the treatment 1 The application of soap lina- 
ment, spirit of turpentine, sulphate of copper, and tincture 
of cantharides is recommended. The best remedy is to smear 
the part with the balsam of copaiva. 

Frost Bite. 

What are the symptoms of frost bite? The exposed part 
becomes benumed, stiff* and insensible; these symptons are 
succeeded by heat, swelling, pain, lividity, and suppuration, 
which occurs between the sound and living parts. When 
the cold is long continued so as to affect the internal organs, 
drowsiness, shivering, rigidity of the limbs, diminution of 
the circulation, and profound sleep, terminating in death. 

What is the treatment? Snow and ice water should first 
be applied, and the parts carefully handled; when the nat- 
ural temperature is restored it should be treated according 
to the circumstances of the case in regard to inflammation, 
tendency to mortification, &c. When the patient is insen- 



192 



SURGERY. 



sible the indications aro to restore the respiration, and emu- 
lation, by sternutatories, yolatiles, frictions, &c. 

Burns. 

How are burns divided and what are their symptoms? — 
They are divided into superficial, ulcerated and carbuncu- 
lous. In the first there is simple erythema; in the second 
vesication; and the third is where the cutis and adjoining 
parts are disorganized, with severe constitutional distur- 
bance in proportion to the extent of the injury. In the se- 
eond variety the constitutional disturbance may be great 
also, in proportion to the extent of surface involved. 

At what periods may burns prove dangerous? When the 
shock is first received ; from reaction or inflammation; and 
at tne suppurative period. 

"What is the treatment? In superficial burnsthe applica- 
tion of carded cotton is highly extolled; also cooling appli- 
cations, either by the direct application of cold, or £ by evap- 
orating lotions. The essence of peppermint before' vesica- 
tion takes place is one of our best application to assauge 
pain, and prevent the effusion of serum. 

In the second variety, emollient applications should be 
used, and a linament of lime water, and flaxseed oil, or 
sweet oil spread on cotton batting is as good an application 
as we can make. In the third variety, the stimulant plan 
internally and externally should be adopted, until reaction 
takes place, when the anti-phlogistic system may become 
necessary. Opium is generally necessary to relieve pain 
and constitutional disturbance. 

The after treatment of the ulcers should be governed by 
the circumstances of the case, always bearing in mind the 
strong tendency to contraction of the cicatrices, which should 
be counteracted by splints, rollers, &c. The treatment of 
these cicatrices has been recently much improved^by means 
of plastic operations. 

Wounds. 

How are wounds divided? Into incised, punctured, pen- 
etrating, contused, lacerated, poisoned, and gun shot. These 
may be divided into wounds of the head, face, neck, chest, 
belly, and extremities. 



SURGERY. 



193 



Incised Wo u n ds , 

What are the dangers of incised wounds? These are 
the least dangerous of the wounds except from hemorrhage, 
which may be troublesome when a sharp instrument is used 
or large blood vessels divided. 

What is the proper treatment? It is to suppress the he- 
morrhage, clear the wound of all foreign matter, and retain 
the edges in contact. 

What are the means of suppressing hemorrhages'? Liga- 
tures, compression, and the actual cautery. The tenaculum, 
needle, and forceps, are the instruments employed to secure 
bleeding vessels. Ligatures are made of thread, silk, or 
leather. Compression may be performed by the tourniquet, 
or by rollers and pledgets. 

The actual cautery should never bo employed when the 
bleeding vessels can be secured. 

What are the means used for retaining the edges of the 
wound in contact? Adhesive straps, bandages, and sutures; 
the object of which is to produce adhesion. 

There are two sutures in use; the twisted, and the inter- 
rupted. 

Punctured Wounds. 

How are punctured wounds produced? By sharp narrow 
instruments such as needles, pins, thorn >, splinters of wood, 
nails, &c. 

What are the dangers from punctured wounds? Tetanus, 
and large collections of matter under the fascia. 

^ What is the tr< atment? A soft poultice is generally suffi- 
cient; but if there are indications of the formation of matter, 
or nervous symptoms arise, the wound should be freely dila- 
ted, and kept open. The use of opium may become neces- 
sary. 

Penetrating Wounds. 

What are the characteristics of penetrating wounds? 
They are more extensive than punctures, and generally pro- 
duced by the small sword, bayonet, or dirk. 

What are the dangers from" penetrating wounds? They 
may be dangerous from entering large "cavities, injury to 
important bloodvessels, nerves, or viscera; or they mav 
cause extensive collections of matter in deep seated parts." 

17* 



194 



SURGERY 



What is the treatment} The first object is to suppress 
hemorrhage; which may require extensive incisions. If the 
bleeding vessel is in the chest or abdomen deep seated, the 
plan is to diminish the general activity of the circulation by 
blood letting. In other respects they are to be treated as 
the constitutional, and local symptoms may demand* 

Contused Wounds* 

What are the dangers from contused wounds? Gangrene 
is very liable to take place when they are extensive, and se- 
vere. 

What is the treatment? They should be treated on com- 
mon antiphlogistic principles locally, and generally* 

Lacerated Wounds* 

What are the dangers of lacerated wounds? They are 
dangerous from their extent, and the parts involved, They 
bleed sparingly, but are liable to secondary hemorrhage, 
and to gangrene. 

What is the treatment? Bring the parts as near together 
as possible, and treat the constitutional effects as the condi- 
tion of the patient may demand. 

Poisoned Wounds. 

How are poisoned wounds produced? Generally by in- 
sects, serpents, rabid animals, &c. 

What is the treatment? In the sting of bees, or wasps, 
the local application of common salt, c«dd water, aqua am- 
monia, &c, are useful. In the bites of serpents, olive oil, 
aqua ammonia, arsenic, &c, have some reputation. The ap- 
plication of a cupping glass to the part has proved useful. 
When called early the part should be removed entirely In 
dissecting wounds, apply lunar caustic, after washing clean, 
and take a mercurial purge. 

Gun Shot Wounds. 

What is included under the head of gun shot wounds? 
All injuries occurring from fire arms, explosion of shells, 
rockets, &c. 

What circumstances render gunshot wounds dangerous? 
The extent of the injury, the parts involved, from their in_ 



SURGERY. 



195 



disposition to heal by the first intention, their disposition to 
slough, and secondary hemorrhage. 

What is tho general treatment I It is to suppress hemor- 
rhage, and extract the foreign body when it can be done 
without too much injury to surrounding parts. The applica- 
tions should be simple, such as water dressings, with sugar 
of lead and opium. 

Abscesses. 

What is the treatment of Abscess of the Antruml It is to 
remove one or more teeth corresponding with the floor of 
the antrum; if the matter is not then discharged pass a sti- 
let or small trocar into the cavity from where the tooth has 
been pulled and push it into the antrum gradually. Use as- 
tringent injections four or five times a day, and keep a bit of 
bougie or tent in the opening until the discharge and inflam- 
mation subside. 

What is the treatment of Mammary Abscessl The first 
step is to prevent them if possible by the repeated applica- 
tions of warm vinegar, topical bloodletting, and a general 
antiphlogistic course. 

If we find suppuration must take place, apply warm poul- 
tices, and open in a depending part when fluctuation is 
perceived. 

What are tho symptoms of Lumbar Abscessl Pain in the 
lumbar region, extending from the kidney down to the out- 
side of the thigh, testicle of the side drawn up, and pain in 
the spermatic chord. These are followed by rigors, loss of 
appetite, and hectic. It sometimes points below the groin, 
sometimes it passes through the ischiatic notch, and in oth- 
er cases passes down near the rectum. The discharge is gen- 
erally thin and gleety, mixed with small flocculi resembling 
curds, or cheese. 

What is the treatment? Very few recover. In the early 
stages the antiphlogistic course should be adopted, but when 
matter is formed an opposite course should be pursued. 

When the abscess is opened it should be done by a small 
valvular incision, then closed for a time, and again opened, 
so as to draw off the matter in a gradual manner. 

Ulcers. 

How are ulcere* divided? Into healthy, unhealthy, and 



196 



SURGERY, 



specific. The first comprehends but one species, the simple 
ulcer. The second contains two species, the irritable and 
indolent ulcer. The third contains several species the prin- 
cipal of which are ulcers from scrofula, cancer, fungus h ne- 
matodes, syphilis, and syphiloid, scorbutic, herpetic, lupus or 
noli me tangere, &c. 

Simple Ulcer. 

What are the causes of the simple ulcer? Injuries done 
to a sound part by wound, contusion, abcess, or burn. 

What are the characteristics of a simple ulcer? It ex- 
hibits a florid appearance, owing to the small, pointed and 
numerous bright red granulations, which cover it. There 
is a discharge of healthy pus in small quantity, and the 
tendency is to heal. 

What is the treatment? Simply keep the part in a proper 
position, and coyer the sore with some mild fresh ointment 
spread on lint, or linen rag. Dry lint is also a good appli- 
cation. 

Irritable Ulcer. 

What are the characteristics of the irritable ulcer? The 
edges of the sore are ragged, undermined, and sometimes 
almost serrated. The parts beyond the ulcer are red, and 
inflamrned ; the bottom of the ulcer exhibits irregular hol- 
lows which contain a thin greenish, or red acrid matter; and 
in place of healthy granulations may be found a dark red 
spongy mass, painful, and bleeding on the slightest touch. 

What are the causes of the irritable ulcer ? It proceeds 
from local causes influenced by the state of the constitu- 
tion, and habits of the patient. The digestive organs in 
particular are generally disordered ? 

What is the tieatmont? The constitutional condition 
should be attended to; and if the digestive organs are af- 
fected resort should be had to steady purging and antimoni- 
als, if not contra-indicated. 

The proper local applications are poultices, fomentations, 
cream, a weak solution of the nitrate of silver, and opium 
mixed with poultices or sprinkled over the sore. The limb 
should be elevated and pressure and bandaging avoided. 

Indolent Ulcer. 

What are the symptoms of the indolent ulcer? The 
granulating surface has a flat shining aspect, and is partly 



SURGERY. 



197 



covered with a pellicle or crust pf a whitish or dark grey- 
color. Sometimes the surface is dry but generally there is 
a discharge of a viscous cohesive fluid. The edges are ele- 
vated, smooth, and rounded; beyond the ulcer the parts 
are swollen, and indurated. The pain is trifling. 

What is the treatment of the indolent ulcer I Where an 
ulcer shows a disposition to become indolent, resort should 
be had without delay to escharotics, adhesive straps, or the 
roller. If these do not effect a cure the edges should be 
pared away, and the whole surface pencilled with the veg- 
etable or lunar caustic. The oak bark poultice followed in 
a few days by the adhesive strips or roller will sometimes 
cure. These ulcers frequently require stimulating applica- 
tions, such as lunar caustic, savin powder, cantharides, cap- 
sicum, corrosive sublimate, &c. Dr. Physick considered a 
combination of gj of simple cerate, and 3ji of British oil 
as the best cicatrizer. The dressings should be changed 
repeatedly. 

Constitutional remedies also exert a powerful influence, 
and such remedies as blue pill, and other mercurials should 
be resorted to. 

In healing chronic ulcers care should be taken to estab- 
lish an issue in some part of the body; otherwise the stop- 
page of a long established discharge, may give rise to apo- 
plexy, or other serious disturbance. 

Varicose ulcers will usually heal with adhesive straps, 
the roller or laced stocking; but in many instances the en- 
larged veins can only be relieved by an operation. 

Scrofula. 

What are the premonitory signs of scrofula? A delicate 
complexion of a lively red color, mixed w T ith a clear white, 
the lips red, and the upper one especially thick and protu- 
berant. The pupils of the eyes large, and the conjunctiva 
free from vessels. These are some of the symptoms which 
denote the scrofulous constitution. 

Children are more subject to it than adults. 

"NA hat are the symptoms of scrofula? A scrofulous tu- 
mour is first a simple enlargement without pain, or unnatu- 
ral heat; in a short time it becomes tender on pressure, and 
the heat is augmented; inflammation then generally sets in, 
and it terminates in abscess, and ulceration, but not always. 
The matter discharged from abscesses of this kind is thin, 
gleety, and mixed with floeculi. 



198 



SURGERY. 



What are some of the most obvious causes of scrofula? 
Cold and moisture, hereditary influence, irrogularities of diet, 
meagre and unwholesome provisions, an impure or tainted 
atmosphere, deficient clothing, fevers, filth, fatigue, mental 

anxiety, &c. 

What is the proper treatment for scrofula? Invigorate 
the general system by a light nourishing diet, tonics, and 
such other means as the general state of the health may re- 
quire. Flannel should be worn next the skin, and moder- 
ate exercise persoverod in. Iodine, and its compounds both 
generally and locally, are valuablo in the treatment of most 
cases of scrofula. 

For the scrofulous ulcer, dry lint, the iodine cataplasm, 
astringent washes, and moderate pressure, are recommended. 

Cancer. 

What is understood by the term Scirrhus? It is the fore- 
runner of cancer; and characterized by a preternatural den- 
sity or induration of the soft parts, difficult of resolution, 
and prone to ulceration. It is unequal in surface, uncom- 
monly heavy, and the skin covering it puckered, and of a 
faint bluish or leaden hue; with a vehement peculiar, lanci- 
nating pain in the part. 

What is the treatment of cancer? Extirpation is the re- 
medy most to be depended upon, but from the constitutional 
nature of tho affection this does not always succeod. 

Gonorrhoea. 

What are the symptoms of gonorrhoea? They are a slight 
titilation of the glans penis, tumidity of the lips of the ure- 
thra, and more or less inflammation of the glans, and pre- 
puce. These are followed by a discharge from the urethra 
of a thin whitish fluid, speedily changing into a yellow pu- 
rulont matter of a peculiar smell, attended with pain along 
the course of the urethra in discharging the urine. 

What is the treatment? The constitutional treatment in 
severe cases is blood-letting, purgatives, and low diet. — 
Stimulating diuretics, especially balsam of copaiva, and cu- 
bebs are beneficial. When the ardor urinae, and dischargo 
diminish we may use astringent injections. 

Sypilis. 

What is understood by the syphilitic virus? It is a spe= 



SURGERY. 



109 



cific morbid poison, which applied under certain conditions 
to any portion of the human body will there determine defi- 
nite and characteristic local phenomena, and if absorbed 
contaminate the system. 

How is syphilis divided ? Into primary or local, of which 
chancre is the exponent. And consecutive, general, or con- 
stitutional, which is always the consequence of chancre. 

"What is chancre ] It is a primary veneral sore, produced 
by the direct action of the syphilitic virus on the inoculated 
part. 

What are the different ways that chancres may be devel- 
oped] By pustule, ulceration, and small abscess. 

What are the stages? There are two; one of ulceration, 
and the other of cicitrization. 

What is the difference in the properties of the matter in 
these two stages'] In the first it is inoculable, and in the 
second it is not. 

How are chancres divided as to location? Into external, 
and larvated or concealed. 

How are they divided in regard to their characteristics? 
Into follicular, indurated, phagedenic, and furunculous. 

What is the index of constitutional affection? Indura- 
tion of a chancre. 

Are buboes classed among the primary or secondary symp- 
toms of syphilis? The primary; and may occur both from 
sympathy and absorption. If from absorption, they are in- 
oculable, and are included in the term furunculous chancres 
or chancreous buboes. 

What is the treatment of chancre? As it is at first purely 
a local affection, the specific sore should be converted into a 
simple one by the application of caustic. Nitrate of silver, 
protonitrate of mercury, sulphate of copper, potassa cum- 
calce, &c, are used for this purpose soino preferring ono 
and some another. After the separation of the eschar sim- 
ple dressings such as weak solutions of sulphate of copper, 
black and yellow washes, aromatic wine, &c, will be prop- 
er dressings. Larvated urethral chancres may be cauterized 
by Lallemand's instrument. 

How should buboes from absorption be treated? By an- 
tiphlogistics generally; blisters succeeded by a solution of 
corrosive sublimate, and other antiphlogistic applications 
locally; after ulceration they should be treated like chancres. 

What is the proper treatment for chancre when it becomes 



£00 



SURGERY, 



indurated ? Induration being the index of absorption which 
is followed by constitutional symptoms, constitutional rem- 
edies become necessary, and mercury pushed to the extent 
of a very slight impression on the glands is the best remedy. 

What are the constitutional or secondary symptoms? Cu- 
taneous eruptions; inflammation of the eye; inflammation 
and ulcerations of the palate and fauces; induration and 
ulcerations of the glands of the skin; inflammation of the 
osseous and fibrous tissues, neuralgia, &c. 

Are these affections capable of hereditary transmission? 

They are; but the primary are propagated from one to 
another only by inoculation. 

What' is the treatment? By alteratives; among which 
mercury stands first; iodide of potassium, sarsaparilla, arse- 
nic, &c, are also useful. 

Fractures. 

How are Fractures divided? Into simple, compound 
and complicated, and again into transverse, oblique, com- 
minutive, and longitudinal. A simple fracture is a mere 
separation of tho bony fibres unattended with severe contu- 
sion or external wound. A compound fracture is accom- 
panied with an external wound or protruded bone. It is 
called complicated when the bone is broken in more than 
one place, combined with ^luxation, laceration of large ves- 
sels, or rupture of ligaments, tendons. &c, or other exten- 
sive injury. A fracture is transverse when its direction is 
perpendicular to the axis of the bone, oblique when it de- 
viates from the perpendicular direction, comminuted when 
the bone is broken in several places, and longitudinal when it 
runs parallel with the axis of the bone. 

What are the symptoms of fracture? Generally there is 
crepitus, and when it exists can be elied on. There is 
also usually deformity, pain, swelling, nd inability to use, 
and move the limb. 

What is the prognosis in fractures? It will depend much 
upon the extent of the injury, constitution, and ago of the 
patient, the kind of fracture, and the bone broken. Com- 
plicated and compound fractures are the most dangerous. 
An oblique fracture is more difficult to manage than a tran- 
verse one, owing to muscular contraction. 

What is the treatment for fractures? Tho general indica- 
ting arc to prevent or subdue i flamma on, and to coaptate 



SURGERY, 



and retain the fragments in contact, until they are restored 
by callus. 

"The former is best accomplished by the anti-phlogistic 
course and position; and the latter by extension, counter-ex- 
tension, position, splints, compresses, and bandages. It re- 
quires from two to eight weeks to produce consolidation; 
and somo time longer before complete restoration takes 
place, 

Fracture of Ithe Lower Jaw. 

What are the symptoms of fraeture of the lower jaw? — 
Crepitation can generally be detected, and the teeth will be 
found irregular, and often loosened. 

What apparatus is necessary? A compress, and a ban- 
dage united in the centre and divided at each end near to 
the middle, so that each loose end may be tied to the one of 
the opposite side ; one of them over the top, and the other 
at the back part of the head; the united portion of the ban- 
dage covering the compress and fracture. 

The patient must be nourished with broth or other thin 
fluid between the teeth. 

Fracture of the Vertebrae. 

What is the treatment for fractures of the vertebrae? If 
the patient should survive the immediate effect of the inju- 
ry; the antiphlogistic course should be adopted, particularly 
one to relieve inflammation of the spinal marrow ; and the 
urine must bo drawn off frequently by the catheter. 

Fracture of the Ribs. 

What are the symptoms of fracture of the ribs? They are 
not always distinct unless crepitus exist ; there is generally 
little displacement; but usually pain on respiration, (espe- 
cially in the recumbent posture), at the seat of the injury; 
which is increased upon coughing. 

What is the treatment? "A roller 6 or 7 inches wide 
should be applied tightly round the chest so as to cause the 
patient to breath by the diaphragm. The general symp- 
toms should be attended to at the same time." 

Fracture oj the Sternum. 

What are the symptoms? An incessant grating of the 
fragments upon each other during respiration. The direc- 
tion cf the fracture is commonly transverse. 

18 



202 



SURGERY. 



What is the treatment? The indications are to prevent, 
or subdue inflammation, and to appease the incessant cough 
and difficult respiration that usually attend. A roller should 
be applied also, as in fracture of the ribs. 

Fracture of the Clavicle. 

What are the symptoms'? Crepitation, depression of the 
humeral beneath the sternal fragment, the shoulder falling 
below the level of the opposito one, and the peculiar incli- 
nation of the head and body towards the affected side. 

What is the treatment? The indications in fracture of 
the clavicle are to carry the shoulder upwards, outwards, 
and backwards; and to retain it in this position by appro- 
priate apparatus, of which there is a variety in use, some 
surgeons preferring one, and some another. The plan of 
Velpeau is recommended by Prof. Mussey in which the 
fore-arm is brought across the chest with the hand resting 
on the shoulder of the sound side and secured in this posi- 
tion by proper bandages, and compresses. 

Fractures of the scapula can generally be treated by the 
same position as those of the clavicle. 

Fracture of the Arm. 

What are the symptoms? Crepitation, mobility of the 
fragments, and angular displacement, or a tendency to it. A 
fracture of the neck of the humerus besides the ordinary 
symptoms of fracture, may be distinguished from disloca- 
tion by the rotundity of the shoulder being preserved; 
while in dislocation there is a hollow under the acromion, 
and a tumor in the axilla. 

What is the apparatus necessary for the treatment? A 
long roller, and four narrow splints. 

When the condyles are fractured a roller, and two angu- 
lar splints are necessary. 

Fracture of the Fore-arm. 

What are the symptoms? Crepitation, deformity, and the 
mobility of the fragments. 

What apparatus is necessary in the treatment? Two long 
compresses; two splints 2£ inches wide, and long enough to 
extend from the elbow to the points of the fingers; and a 
roller. 



SURGERY. 



203 



Fracture of the Patella. 

What are the symptoms? The transverse fracture which 
is the most common, is known by the upper half being mov- 
ed upwards on the thigh, and the patient is unable to rise, 
or to walk. 

What is the treatment, and apparatus? The limb should 
be placed in an extended position and flexed on the pelvis. 
The apparatus is a splint two inches wide, long enough to 
extend from the tuberosity of the ischium to near the heel; 
two rollers, each six yards long, and three inches wide; and 
compresses. 

Fracture of the Thigh. 

What are the symptoms of the fracture of the neck? The 
limb is generally shortened, its length can be restored with- 
out difficulty, and reascends as soon as the extension is re- 
moved. Upon rotating the thigh, and placing the hand on 
the trochanter it will turn as it were upon a pivot; whereas 
in the sound bone it describes the arch of a circle the radius 
of which is formed by the neck. 

What part of the thigh is most liable to fracture. The 
middle in young subjects. 

What are the symptoms of fracture of the shaft? There 
are the general symptoms of fracture with shortening of the 
limb, unless it is transverse, in which case the ends are sup- 
ported against each other. 

What are the indications of treatment? The principal 
indications are to keep up extension, and counter-exten- 
sion, for which there is a great variety of apparatus in use. 

Fracture of the Leg. 

What are tie most common varieties ? Oblique and trans- 
verse fractures of the middle, but it is liable to every varie- 
ty and in any part. Sometimes one bone is broken, and at 
others both. A variety of apparatus is used in treatment. 

Luxations. 

What is a luxation or dislocation? It is the removal of 
the head of a bone from its corresponding articulating cavity. 

How are the varieties of dislocation designated ? By the 
terms simple, and compound ; primitive, and consecutive; 
recent, and old; complete, and incomplete. 



204 



SURGERY. 



Simple luxation is where there is a mere removal of tlw 
head of the bone; compound, when an external wound com- 
municates with the cavity of the joint; primitive, when the 
head of the bone continues in the unnatural position it first 
assumed; consecutive, when it is removed and becomes fix- 
ed in another; recent, and old relate to the duration; com- 
plete, and incomplete denote total and partial displacement. 

How may luxations be distinguished from fractures? By 
Want of .crepitation, by the peculiar distortion and rigidity 
Of the limb, and the shape of the joint. 

What are the means generally employed? Constitutional, 
and local means are both often necessary. Among the for- 
mer, are blood letting, warm bath, nauseating emetics, &c. 
The latter are extension, and counter-extension. 

In how many ways may the Lower Jaw be luxated, and 
what are the symptoms? Only in one; — anteriorly. The 
condyles are displaced, the mouth is thrown open and can- 
not be shut, and the coronoid process projects under the 
cheek bone. 

What is the treatment? The surgeon places his thumb 
d( ep in the mouth, and rests them upon the posterior molar 
teeth while the fingers are carried beneath the chin and 
base of the jaw. Pressure should be made downward by 
the thumb, and the chin elevated at the same moment; by 
Which reduction may be effected. 

How many ways may the Clavicle be luxated? It may be 
luxated at either end; and the sternal portion in three di- 
rections; forward, backwards, and upwards. They are all 
easily distinguished by their peculiar deformity. 

What is the treatment? The same as for fracture of the 
same bono. 

How many ways may the Arm be luxated? Downwards, 
forwards, backwards, and a consecutive dislocation up- 
wards. 

How may \ho Fore-arm be luxated? Backwards, laterally, 
and forwards by a previous fracture of the olecranon. 

What are the different luxations of the Thighl Upwards, 
and outwards, on the dorsum of the ilium; downwards and 
inwards into the foramen ovale; upwards and forwards on 
the pubes; and backwards into the ischiatic notch. 

The first may be known by a prominence near the supe- 
rior spinous process of the ilium formed by the great tro- 
chanter, together with a shortening of the limb, and an in* 

nation of the foot inwards 



SURGERY. 



205 



The second by the limb being lengthened two or three 
inches; the foot is turned outwards, and the head of the 
bone in thin subjects may be felt in the foramen ovale. 

The third by a hard tumour above Pouparts ligament; the 
limb is shortened about an inch, the foot is turned outwards, 
and the trochanter major is in front of the anterior superior 
spinous process of the ilium. 

The fourth by the limb being shortened half an inch, and 
the foet slightly inclined inwards. 

What is the treatment? Extension by pulleys, and coun- 
ter extension by a band passing over the perineum and rest- 
ing against the tuber of the ischium. 

How may the Patella be luxated ? Outwards, inwards, 
and upwards when the ligament of the patella is ruptured. 

In what direction may the Ankle be luxated? Inwards, 
outwards, forwards, and backwards; all of which may be 
easily recognized. 

Diseases of the Boxes and Joints. 

To what diseases are the bones liable? Caiies; necrosis; 
exostosis; spina ventosa; osteo-sarcoma; rnollites and fragi- 
iitasossium; and rachitis. 

Caries. 

Vv 'hat is caries? It is an ulceration of bone. 

The soft or spongy bones are the most liable to caries. 

What are the symptoms ? The affected part swells, there- 
is a softening of the bone, and it crumbles away; there is 
also a discharge of foetid blackish matter, and a luxuriant 
growth of pale fungous granulations. 

Wliat is the treatment ? When it is dependent upon a 
syphilitic, scrofulous, scorbutic, or any constitutional disor- 
der, general remedies should be resorted to. When it pro- 
ceeds from local injury, the indications are to combat in-^ 
flammation, keep the parts at rest, and remove diseased por- 
tions of bone as they become loose. Mineral acids, and gas- 
tric juice have also'been applied with benefit. Blisters, is- 
sues, setons, and steady purging are serviceable in constitu- 
tional caries. . . 

Caries of the Spine. 

What are the symptoms? The patient complains of numb 
18* 



206 



SURGERY. 



ness or an uneasy sensation in the lower extremities, is lan- 
guid, easily tired, and apt to trip or stumble in walking. 

There is often flatulence, sick stomach, and derangement 
of the digestive organs. Paralysis of the lower extremities 
occurs in the advanced stages of the disease. There is more 
or less protuberance at some portion of the spinal column; 
the spinous processes of which project, and create consider- 
able deformity. The most common seat is the dorsal verte- 
brae. 

What is the treatment? In the commencement benefit 
may be derived from leeches, blisters, and caustic issues; 
the latter of which it is often necessary to continue for a 
long time. The condition of the bowels, and diet of the pa- 
tient should be strictly attended to, the recumbent posture 
enjoined, and at the same time the benefit of fresh air 
should bo given. 

Necrosis. 

What is necrosis? It is where there is destruction of the 
vitality of bone, and differs from caries as sphacelus differs 
from ulceration. 

What is the treatment ? It is to removo the dead pieces 
of bone when formed. 

Exostosis. 

What is exostosis? It is an enlargement of the bony 
Structure, and is divided into laminated, circumscribed, tu- 
berculated and spinous exostosis. The bones generally 
afTocted are those of the cranium, lower jaw, sternum, ribs, 
and extremities. 

What is the treatment? When it becomes troublesome 
it should be attempted by general remedies, and low diet. 
It these fail it should be extirpated. 

Spina VentGsa. 

What are the symptoms of spina ventosa? It is a tumor 
involving the whole circumference of a bone, consisting of 
an osseous shell perforate 1 with numeroiiSjholes, containing 
sometimes a thin sanies mixed with portions of lymph or a 
chees) substance. 

What is me treatment? A cure may sometimes be pro- 
duced by Ion fr continued pressure; another mode of treat- 
ment ig to make an Opening into the cavity, and throw in 



SURGERY. 



stimulating injections, or by cutting instruments excite such 
a degree of irritation as to cause it to fill up with granula- 
tions. If this fail amputation must be resorted to. 

Osteo Sarcoma. 

What is osteo sarcoma? It is a malignant disease of the 
bones. The tumor forming the diseased part is composed 
of thin bony plates arranged so as to form cells which con- 
tain a cheese-like or fleshy matter, or a thin gelatinous fluid. 

What is the treatment I In the early stages constitutional 
remedies may avail something; of which the compound de- 
coction of sarsapaila with corrosive sublimate is perhaps the 
most efficient. Leeches anc blisters have also been applied 
locally. Amputation when practicable is the only remedy 
likely to be permanently beneficial, even this often fails, 
and the disease returns, and attacks some of the internal or- 
gans, or another part of th e osseous svstem . 

Mollites Ossium. 

What are the symptoms? The bone looses its natural 
firmness; both the animal and saline parts diminish until 
mere shells are left which are very soft. It is a very rare 
disease. 

What is the treatment ? Treatment is of little use ; and 
oil that can be accomplished is to support the patient's 
strength by tonics, and nutritious diet. 

Rachitis or Rickets. 

What are the symptoms? Disorder of the digestive or- 
gans, swelling of the abdomen, emaciatian, dryness or dis- 
coloration of the skin, and blackness of the teeth. These 
symptoms are followed by distortion of different parts of the 
body, which in bad cases become very much deformed. 

What is the treatment? To strengthen the system by 
tonics, and keep the stomach and bowels in proper condi- 
tion. Good ^nutritious diet consisting of animal food has 
boen recommended, also frictions, and frequent bathing in 
salt water. 

Coxalgia or Hip Disease. 

What are the terms used to denote this disease? Morbus 
eoxarius, ischias, spontaneous luxation of the os femoris, 
scrofulous caries of the hip, and abscess of the hip joint. 



MB SURGERY, 

What are the symptoms? The first symptom is a slight 
pain in the knee, and emaciation of the limb; then pain is 
felt about the trochanter and groin which varies in different 
cases, and is increased by pressure upon the hip joint. In 
some cases anchylosis is established apparently without the 
formation of pus; while in others there is a large abscess 
formed, which discharges itself by one or more openings. — 
During this process the patient is sometimes worn out by 
hectic and dies; at other times anchylosis takes place; the 
openings heal up, and a cure is accomplished with consid- 
erable deformity. 

What is the treatment? The habit of bending the thigh 
on the pelvis, and the leg on the thigh, should be corrected 
by -curved splints gradually changed for straighter ones. — - 
Before the abscess forms, blisters, cupping and issues should 
be used, conjoined with steady purging, vegetable diet, and 
perfect rest. 

During the suppurative stage the strength of the patient 
should be supported, and such other constitutional remedies 
employed as are indicated. 

Fungus Articuli, or White Swelling. 

What is comprehended under these terms? Inflamma- 
tion of the synovial membrane. 

Morbid change of structure in the synovial membrane. 

Ulceration of the cartilages of joints. 

Scrofulous disease of the joints having its origin in the 
cancellous structure of the bones. 

What is the treatment of the first variety? In the acute 
form blood-letting, purgatives, low diet, Sec. The affected 
part should be kept in a state of quietude, and elevated. — 
As internal remedies mercury and sarsaparilla are often in- 
dicated. 

What is the treatment for the second variety'? Amputa- 
tion is generally the only remedy, and this does not always 
succeed. , / 

What is the treatment for the third variety? Caustic is- 
sues, blisters, setons and absolute rest, anchylosis generally 
takes place, and may be considered as the safe guard of the 
patient. 

What is the treatment for the fourth variety ? The rem- 
edies for scrofula should be resorted to; also rest and adhe- 
sive s f rins. In all these varieties when matter is formed in 



SURGERYi 



the joint it should not bo let out but an effort made to pro- 
duce absorption, 

Hydrarthus or Dropsy of a Joint. 
What is the treatment? Blisters and well regulated pres 
sure will generally be appropriate treatment. 
Moveable Cartilage, 

What is the treatment?- If a laced knee-cap, bandage?, 
&c, have been tried without relief recourse may be had to 
an operation for its removal. 

Anchylosis. 

How is it divided] Into complete and incomplete. 

In the incomplete variety the ligaments, tendons and sur- 
rounding cellular membrane are involved and there is partial 
movement of the joint. 

In the complete form the extremities of the bones often 
become perfectly united and identified. 

What is the treatment "? Friction with stimulating arti- 
cles and judicious movement of the joint, in the incomplete 
variety. 

Diseases or the Arteries. 

To what diseases are arteries subject ? To inflammation* 
suppuration, ulceration, sphacelus, calcareous concretions, 
uniform dilation of the coats, and aneurism. 

Aneurism. 

What is an aneurism ? It has been defined to be a pulsa= 
ting tumour formed of arterial blood} 

What are the varieties of aneurism ?- True, false, circum- 
scribed, diffused, varicose aneurism, and aneurism by anas- 
tamosis. 

By true aneurism is understood a simple dilation of all the 
coats of an artery, or the internal and middle ruptured, 
while the cellular coat remains entire; by false aneurism a 
rupture or wound of the three coats, so that the blood is 
extravasated among the surrounding parts. 

The terms circumscribed and diffused relate to the form 
of swelling, or extent of extravasation. 

What are the symptoms of aneurism? The tumour is 
first small, free from pain, and disappears easily bv pre?*- 



510 



SURGERY. 



sure, but returns when the pressure is removed. As it en- 
larges the pulsation is lessened, and when much enlarged 
the integuments covering it become paintul, livid, crack, 
ulcerate, and hemorrhage if not arrested sooner, or later de- 
stroys the patient. 

What is the treatment? Some benefit may accrue by fre- 
quent and repeated bleeding: rigid abstinence; confinement 
to a horizontal position; the internal use of digitalis, astrin- 
gents, and refrigerants; these remedies cannot be depended 
on but should be pursued when the ligature from any cause 
is ^impracticable. The ligature may'be considered as the 
only means upon which reliance can be placed, and even 
this often fails, and secondary hemorrhage is the conse- 
quence. 

What are the rules for the application of the ligature in 
aneurism? The surgeon should cut for a sound part of the 
artery above the sac; penetrate cautiously until the pulsa- 
tions of the artery are discovered; pass ananeurismal needle 
round, armed with a ligature, detaching it as little as possible 
from its connections; the ligature should be firmly tied, one 
end cut off, and the ether left hanging from the wound, 
which should be brought together by adhesive straps. 
Aneurism by Anastamosis. 

What are the symptoms'? It is a tumour formed by a 
congeries of small arteries and veins with an intermediate 
cellular structure; as itTenlarges it acquires a thrilling pul- 
satile or jarring motion. 

What is the treatment? 

Compression, and excision are the means proposed for 
curing this disease. 

Varicose Aneurism. 

What is varicose aneurism? It is that form of the disease 
in which a communication is established between an artery 
and a vein. It may be produced in any part of the body 
where a large artery and vein are near each other, and hap- 
pen to be punctured at the same time. 

What is the treatment? Compression, and the ligature 
are the means recommended. 

Diseases of the Veins. 

What are the diseases of the veins? Inflammation, and 
varicose enlargement 



SURGERY. 



Varicose Veins. 

What are tho symptoms? The disease is almost entirely 
confinod to tho veins of the lower extremities. In the com- 
mencement nuAierous small circumscribed swellings may 
H3 observed; at length the whole venous trunk and branch- 
tfs become enlarged, run in a serpentine course, and appear 
^notted. As they enlarge the support afforded by the valves 
is diminished until they are entirely lost. The surrounding 
cellular membrane becomes inflamed, and gives rise to pain* 
ful ulcerations. 

What is the treatment? Compression with a roller, or 
laced stocking; astringent washes; an elevated position ot 
tho limb ; and obliteration of the diseased vein by an opera- 
tion, of which there have been several kinds proposed and 
practised; viz: the ligature, tho section, and the excision of 
the vein; all of which are attended with more or less danger. 

Cirsocele and Varicocele. 

What are the symptoms?- Cirsocele is an enlargement or 
varicose state of the vein3 of the spermatic cord. Varicoce- 
le is a varicose state of the veins of the scrotum. When ex- 
amined the whole cord appears like a bundle of knotted, 
and tortuous veins; and feel like a bunch of worms wrapped 
round and twisted together. The tumour subsides on assu- 
ming the horizontal position, and reappears on standing. 

W T hat is the treatment ? A bag truss should be worn that 
will suspend the testicles, and give them a firm support. — 
Cold astringent washes are also recommended. There are 
several operations proposed, and practiced for this disease 
upon which the profession is not yet very well settled. 

Ixjueies or the Head. 

Fractures of the Skull. 

What aro the varieties of fracture of tho skull? There are 
several; fissure, counter fissure, depressed, double depre^s- 
ed^or camerated, stollated, and punctured fracture. 

Fissure is a simple crack or division; counter fiissure is a 
separation produced at a point opposite to that where the 
force was applied; depressed fracture is when the bone3 are 
forced below their natural level; camerated when ihe sides 
decline towards tho centre; stellated when it radiates from 



SURGERY. 



a contra resembling a stai ; and punctured when produced 
by a pointed instrument. 

What is the treatment) In simple fracture where the 
brain, or membrane are uninjured little, or no treatment is 
necessary. The rule in all cases is not to interfere unless 
the contents of the skull are affected, and of this the symp- 
toms must be our guide. In cases, however, where sharp 
points, or ragged edges of bone exist, they may be removed 
by appropriate instruments to prevent them fiom irritating 
the dura mater, or other adjacent soft parts. 

Concussion of the Brain. 

What are the symptoms? In slight cases there is vertigo, 
sickness of the stomach, trembling of the limbs, dimness of 
vision, &c, In severe cases there is insensibility, coldness 
of the skin, relaxation of the limbs, feeble and irregular 
pulse, difficulty of breathing, (not however generally sterto- 
rous), and dilated pupils. 

These symptoms may after a time subside gradually, 
when a determination of blood to the brain follows, of grea- 
ter, or less severity. 

What is the treatment? If called early, be careful that 
the importunities of the bystanders do not determine you to 
bleed before the pulse rises and reaction is established, when 
it may be proper. Content yourselves with administering 
a little cold water, or if the depression is very great, wine in 
small quantities, and with caution. Generally external stim- 
ulants, such as mustard plasters, will be sufficient to rouse 
the system, and are free from the injurious effects of alcohol 
upon the brain. If inflammatory symptoms come on, blood 
letting, purgatives, low diet, &c, with cold to the head, an 
elevated position of it, and blisters become highly necessary. 

Compression of the Brain. 

What are the causes, and symptoms? It may arise from 
depressed fracture, effused, or extravasated blood, and from 
suppuration within the brain, or its membranes. 

When symptoms of compression come on from extravasa- 
tion there is generally an interval between the injury and 
the appearance of the symptoms; and when this occurs may 
be considered as characteristic of compression from extrav- 
asatad blood. When these symptoms are caused by matter 



SURGERY. 



213 



k is the result of inflammation, and does not follow imme- 
diately an injury of the skull. 

If compression arise from either of the preceding causes 
it may be known by the pulse becoming slow, and regular; 
the pupils dilated, and insensible to the strongest light; 
breathing stertorous, slow, and difficult; the limbs loose, or 
yielding, perhaps paralytic; and insensibility. These symp- 
toms will be sufficient to distinguish it from concussion, 
where the distinction is well marked; but often the symp- 
toms are inter-mixed so as to create eonfusi-on and doubt in 
the mind of the surgeon. 

What is the treatment ? Blood letting^ purgatives, &,c. 
will often alone relieve symptoms of compression. 

When the bones are depressed they should be elevated, 
or if produced by extravasation the trephine m=ust be resort- 
ed to and the coagulum removed. 

What are the instruments required for operations on tho 
skull? Two or three trephines, the largest about an inch in 
diameter, and the smallest half an inch; a Hey'ssaw; a len- 
ticular; raspatory; trepan forceps ; two elvevators, a small 
brush, tooth pick, or probe; tenacula; sponges; crooked 
needles; ligatures and a scalpel. 

What are the objects to be attained in the application of 
the trephine ? To make an opening for the removal of co- 
agulated blood, and for the introduction of the elevator bee 
neatk a depressed bone. For the former a large trephine 
s'honld be used, and for the latter a small one. It is not how- 
ever always necessary to use the trephine in depressed bono, 
as" there is often sufficient space to pass the elevator be- 
tween the fragments and restore them to their proper posi- 
tion. 

To what parts of the skull may the trephine be applied? 
To all parts, except to the occipital bone. 

When it is necessary to trephine the inner table of tho 
frontal sinus, two trephines should be employed; a large 
one for tho external portion, and a small one for the inner. 

Inflammation of the Brain, 

What are the symptoms? The face becomes flushed, the 
eyes red, and tender to light, pupils contracted, skin hot, 
pulse hard and quick, and the tongue dry. The pain in tho 
head is also severe, and the wound if there be one discharff 
19 B ° 



214 



SURGERY. 



es a sanious matter. Rigors, follow, which arc dangerous 
symptoms. Delirium, hemiplegia, and convulsions may also 
como on in the latter stages of the disease. 

What is the treatment? The most active antiphlogistic 
course should be pursued; blood letting, generally and lo- 
cally, purgatives, blisters, &c. If suppuration take place the 
trephine may be used but the chance of the patients recove- 
ry is very small. 

Fungus Cerebri or Encephalocele. 

What are the symptoms? It is a tumour having the ap- 
pearance of a vascular organized growth, which sprouts 
from the brain after extensive fractures or the operation of 
the trephine; fills up the opening of the bone, and projects 
beyond the scalp. 

What is the treatment? Light dressings with moderate 
pressure upon the tumour. 

This diseaso is generally fatal. 

Diseases of the Eye. 

Conjunctival Ophthalmia , 

What are the symptoms? A sense of uneasiness or itch- 
ing, an impatience of light, diffused redness of the conjunc 
tiva, pain, heat, and swelling of the globe of the eye; an 
increased secretion of tears, and a feeling as though there 
was a lodgement of sand in the eye. If the inflammation 
proceeds there is violent pain in the eyeball, and forehead 
accompanied by fever and other general indisposition.. — 
Sometimes the conjunctiva throws out a fungus beyond the 
margin of the cornea, and at others suppuration takes place, 
followed by destruction of the cornea, and evacuation oi 
the humours of the eye. 

There are several varieties of conjunctival ophthalmia: — 
The catarrhal, purulent, gonorrhceal, and scrofulous. Some 
authors however adopt different divisions of the disease 
from this. 

W r hat is the treatment? In the early stage of simple in- 
flammation it may be easily removed by bloodletting, gene- 
ral and local, purgatives, antimonials in nauseating doses, 
low diet, blisters, lotions of tepid water, a solution of opium, 
or acetate of lead, or sulphate of zinc, if it runs into the 



SURGERY. 



215 



chronic stage cold astringent washes, and stimulating oint- 
ments may become necessary. 

For the catarrhal variety the proper remedies are moder- 
ate depletion at first, followed by highly stimulating col- 
lyria, and ointments. 

The purulent variety should be treated upon common an- 
tiphlogistic principles, and moderately astringent washes, 
of which the liquor of the acetate of lead is one of the best. 

The gonorrhoea! variety may be treated upon general 
principles but it is seldom cured. 

The scrofulous variety does not generally require much 
antiphlogistic treatment, but rather a tonic course will be 
indicated. A blister on the nape of the neck kept open, and 
weak solutions of the nitrate of silver, sulphate of zinc, &c. 
applied to the eye will bo found beneficial. 

Sclerotic Ophthalmia. 

What are the symptoms? It is an inflammation of the 
selerotic coat sometimes called rheumatic ophthalmia. The 
pain in the commencement is generally seated in the tem- 
ple, and extends to tho eyebrow and cheek of the side af- 
fected, being most severe at night. There is no purulent 
discharge or intolerance of light; the sclerotic coat is of a 
dingy brick-dust tinge; there is more or less fever and de- 
rangement of the digestive organs. 

What is the treatment? The indications are to restore 
the functions of the stomach, biliary organs, and skin, by 
emetics, purgatives, and antimonial diaphoretics, after which 
bark may be employed to advantage. The best local appli- 
cations are a blister behind the ear, and the vinous tincture 
of opium as a coilyrium. 

Iritic Ophthalmia or Iritis. 
What are the symptoms ? Severe lancinating pain, extend- 
ing from the eyebrow to the orbit, and through the globe of 
the eye to the optic nerve; extreme impatience of light, 
and morbid sensibility. The conjunctiva does not present 
the appearance of inflammation, but there are numerous red 
vessels on that part of the sclerotica connected with the cor- 
nea, also on the anterior part of tho iris, which looses its 
brilliancy, and changes to a reddish or greenish hue. The 
pupil becomes contracted, irregular, and its edge is turned 
backward toward the crystalline lens; lymph is deposited 



216 



SURGERY, 



on the outer surface of the iris in spots and sometimes s# 
copiously as to obliterate the pupil. 

What is the treatment] The antiphlogistic course should 
be carried to its fullest extent. Obliteration of the pupil 
should be prevented by breaking up any bands of coagula- 
ble lymph which may have formed, with the extracts of bel- 
ladonna or strammonium applied to the outer surface of the 
eyelids, or over the eyebrows, two or three times a day, and 
kept on for half an hour at a time. They should not how- 
ever be applied during the height of the inflammation.-- 
When it has a syphilitic origin mercury followed up with 
sarsaparilla should be used. 

Ps or ophthalmia 

What is psoi ophthalmia? It is an inflammation or ulcer- 
ation of the eye lids; whethor caused by small pox, measles, 
scrofula, erysipelas, or any other cause. 

What are the symptons? Children of scrofulous habit 
are most liable to this disease. The inflammation com- 
mences on the edges of the lids, and extends along the con- 
junctiva with pain and violent itching ; suppuration and 
ulceration sometimes occur, and are very troublesome. The 
meibomian glands are always involved, and pour out an ad- 
hesive fluid. 

What is the treatment? In the early stage purgatives 
and low diet, with the local application of solutions of ace- 
tate of lead, sulphate of zinc, or sulphate of copper. In 
the chronic stage the unguentum hydrargyri nitrati applied 
to the edges of the lids will relieve the itching, and dispose 
the ulcerated surfaces to heal. If the disease resists every 
remedy for a long time, blisters behind the ears and a 
course of mercury may be tried* 

Pterygium. 

What is pterygium? It is a thin membranous expansion 
situated on the conjunctiva; generally occupying the inner 
angle of the eye in the shape of a triangle, the apex of 
which looks towards the cornea, and sometimes extends to 
its centre. A pannus is a pterygium on each side which 
meet in the centre of the cornea. There are two varieties, 
the membranous, and fleshy. 

What is the treatment? When it becomes troublesome 
it should be dissected oflf with a pair of curved scissors. 



SURGERY. 



217 



Encanthis. 

What is encanthis 1 ,* It is an enlargement of the lachry- 
mal caruncle, and semilunar fold. It is sometimes malig- 
nant but it is not a frequent disease. The caruncle presents 
a granulated and livid appearance; if the disease continue 
a long time, adjoining parts become involved. 

What is the treatment? Excision of the diseased parts. 

Opacity of the Cornea. 

What are the varieties of opacity of the cornea? Nebu- 
la, albugo, and leucoma. 

Nebula is a superficial opacity produced by chronic oph- 
thalmia, and does not entirely interrupt vision. 

Albugo occupies the lamella or substance of the cornea ; 
it is of a white or pearl color, often accompanied by oph- 
thalmia, and is always the result of an effusion of lymph. 

Leucoma is a dense callous speck of the cornea of a pure 
white or chalk color, and has a polished appearance. It is 
generally produced by a wound or ulcer. 

What is the treatmeat? For the first variety astringent 
collyria, and such other remedies as are proper in chronic 
ophthalmia. The treatment of albugo is generally difficult 
and requires highly stimulating applications of which ono 
of the best is the unguentum hydrargyri nitrati applied by 
a camel's hair pencil to the surface of the speck, once or 
twice a day. Washing the eye with diluted vinegar has 
algo been recommended, 

Leucoma is perhaps seldom or never removed by any 
treatment, 

Ulcer of the Cornea. 

What are the symptoms? It is commonly the result of 
the different varieties of ophthalmia. Sometimes it occu- 
pies the whole cornea, and at others it is a simple cavity 
not larger than the head of a pin, on some particular part of 
the cornea. 

What is the treatment? The sore should be gently 
touched with nitrate of silver until an eschar forms on its 
surface; and when it drops off the caustic should be re- 
newed. When the ulcer assumes a healthy appearance dis- 
continue the caustic, and use mild collyria or ointments, 
19* 



218 



SURGERY. 



Staphyloma. 

What is staphyloma'? It is a thickening and opacity of 
the layers of the cornea with a projection of its anterior 
surface. It may be produced by small pox, purulent oph- 
thalmia, wounds of the eye, &c. 

What is the treatment? There is no remedy; except that 
an operation may be performed to evacuate the humours of 
the eye which will prevent the pain and inflammation caus- 
ed by dust and other extraneous bodies. Blindness of course 
always exists whether the eye is operated on or not. 

Hypopion. 

What is hypopion, and its symptoms? It is a collection 
of purulent matter, formed within the posterior or anterior 
chamber of the aqueous humour. 

There is redness of the conjunctiva, and a } 7 ellow spot 
may bo seen at the bottom of the anterior chamber which 
increases in size until the whole cavity is- filled. 

Pain, intolerance of light, &c, are very severe, In some 
cases the inflammation subsides, and the pus is absorbed. — - 
In others ulceration and sloughing of the cornea may take 
place, followed by a destruction of the eye. 

What is the treatment? A prompt antiphlogistic course 
is the proper treatment. 

Hydr ophthalmia, 

What is hydrophthalmia? It is a dropsy of the eye; and 
consists of a gradual enlargement of the globe, without at 
first much pain or injury to vision; but as the disease ad- 
vances there is pain, impaired vision, &c, which may ter- 
minate in irritation, suppuration, and the loss of the eye. 

What is the treatment? When it is accompanied with 
general dropsy, digitalis, squill, volatile tincture of guiacum, 
and calomel, may be proper. If the accumulation is large 
paracentesis should be performed. 

Obliterated Pupil. 

What are the symptoms? The iris becomes wrinkled, 
and the pupil either entirely effaced or contracted to a very 
small compass, 

What is the treatment? An operation dividing n portion 
of the iris is the only piopcr course. 



SURGERY. 2ia 
Procidentia Iridis. 

What is procidentia iridis' It is a projection of the iris 
through an ulcer or wound of the cornea. The pain and 
intolerance of light are excessive. 

What is the treatment? When it follows a wound of the 
cornea it may be replaced ; but when it proceeds from an 
ulcer it cannot be retained in its natural situation while the 
ulcer exists. The ulcer should be touched with the nitrate 
of silver, and healed as soon as practicable, 

Cataract. 

What is cataract, and the symptoms ? It is an opacity of 
the crystaline lens, or its capsule. They clifter in color and 
consistence. Some are fluid and called milky ; others are 
called gelatinous, caseous, or hard, according to their con- 
sistence. When the capsule is opaque and the lens remains 
transparent, or is absorbed, it is called capsular cataract. If 
a cataract exist from birth it is called congenital. Most ca- 
taracts are of a bluish, or pearl color; some are grey, or 
green; others white; and in some rare instances black. 

The symptoms are a diminution of sight; objects appear 
as if envelopod in mist, or smoke ; and vision is very imper- 
fect when suddenly exposed to a strong light. In a dull 
light the vision is improved ; and when the lens is opaque 
its color will generally indicate the nature of the disease. 
What is the treatment?- An operation is the only treat- 



ment to be depended upon. 

What are the opertions in use for cataract?- Couching or 
depression; extraction; and the absorbent practice. 

The first is done with a needle; and consists in removing 
the crystaline lens downwards and backwards into the vit- 
reous humour. 



Extraction is performed with a knife; and the opening is 
made into the cornea. 

The absorbent practice is founded upon the solvent power 
of the aqueous humour: xhe operation is to break up the crys- 
taline lens, and bring it in contact with the aqueous humor in 
the anterior chani- er It i s done in two ways ; one is to intro- 
duce the needle anteiior ;and the other posterior to the iris, 
so that in one case the cornea is penetrated, and in the oth- 
er the sclerotica. In all i^^ances previous to the perform- 
ance of any operation the system should be prepared by 



220 



SURGERY. 



urging, diet, &c; and stramonium, or belladonna should 
e applied to the parts about the eye. 

Congenital Cataract. 

What is the treatment? An early operation, 

Amaurosis. 

What is amaurosis, and what are the symptoms? It is 
an insensible state of the retina. 

The pupil is of a greenish black color, greatly expanded 
and irregular in shape, has undulating edges, and the strong- 
est light produces no perceptible contraction. 

The pupil is occasionally contracted, and in some instan- 
ces its motions are partially retained. The natural lustre of 
the eye becomes diminished, or lost. 

What is the treatment? When it arises from any organ- 
ic defect the probability of affording relief is small. If it 
proceed from gastric derangement emetics, and purgatives 
will prove useful, followed by tonics. Errhines may also bo 
found beneficial; beginning with the milder, and afterwards 
using the Turpeth mineral combined with powdered lico- 
rice. 

Hordeolum. 

What is hordeolum? It is a red, inflamed, painful tu- 
mour, involving one, or more meibomian glands usually 
seated on the lower eye lid, near the inner angle. 

What is the treatment ? Purgatives, and attention to diet. 
If it becomes indolent apply lunar caustic. 

Encysted tumours of the Eyelid, 

What is the treatment ? Extirpation. 

Eniropeon. 

What is entropeon? It is an inversion of the tarsus or 
its cilia. 

What is the treatment ? When thers is simply an unna- 
tural direction of the eye lashes they should be removed 
with a pair of forceps. 

When the tarsus is inverted and the skin of the eye lid 
relaxed there should be an oval piece removed, and the 



SURGERY, 



sides of the wound brought together. Other operations are 
also practiced. 

Ectropion. 

What is ectropeon ! It is the reverse of entropeon; the 
eye lid being turned outwards instead of inwards. 

What is the treatment ? A portion of the lid of the shape 
of the letter V should be removed from the- outer angle; the 
thickened conjunctiva should then be dissected off, and the 
edges of the wound brought together with a fine suture. 

Diseases or the Nose, asb Asteum. 

Polypus of the Xose. 

Where are polypi of the nose generally attached ? They 
may arise from any portion of the Schneiderian membrane ; 
but are mostly attached to the superior, or inferior spongy 
bones. 

What is the treatment ? They should be removed with 
the polypus forceps by a twisting motion rather than by pul- 
ling in a straight line. 

Ozama. 

What is ozoena? It is an ulceration of the lining mem- 
brane of the nostrils, having a foetid discharge, and some- 
times followed by destruction of the cartilages and bones of 
tha nose. 

What is the treatment ? Bark, iron, mineral acids, muri- 
ate of lime, sarsaparilla, and antimony have been recommen- 
ded. If there is a syphilitic taint connected with it mercu- 
ry will be proper. Locally, a solution of opium and acetate 
of lead may be used with advantage. 

Fungus or Polypus of ti e Antrum. 

What are the symptoms? It is generally a formidable 
affection. The tumour sprouts from the lining membrane 
of the antrum, and grows until it fills the whole cavity; 
pain is then experienced in the cheek and eye of the affect- 
ed side, and the face becomes enlarged. These symptoms 
are followed by distortion of the nose projection of the eye, 
enlargement of the gums, profuse discharges of sanious 
matter, See. 



SURGERY. 



What is the treatment? As soon as the nature of the 
disease is ascertained it should be completely removed. 

Diseases of the Mouth. 

Labium Leporinum or Hare Lip. 

What are the varieties of hare Up ? The single and the 
double. 

What is the treatment? An operation. Some surgeons 
recommend that we should operate immediately after birth, 
or within a few weeks, others that we should wait until the 
child is two or three years old or after the period of the first 
dentition. It is often combined with a deficiency in the 
palate and maxillary bones; in which case their closure is 
more perfect with an early operation. The principal dan- 
ger of an early operation is a liability to convulsions. The 
operation consists in paring the edges of the fissure in the 
lip, and bringing them in contact by the interrupted suture, 
or pins and figure of 8 bandage. 

Manula 

What is ranula? It is an obstruction of one or more of 
the ducts of the sublingual glands; and gives rise to a tu- 
mour or cyst. 

What is the treatment? Lay the cyst open freely, and 
remove a portion of it with scissors. Sometimes the ap- 
plication of caustic becomes necessary. 

Malformation of the Frcenum Lingua, 

What are the malformations of the frsenum linguae? It is, 
sometimes too short, so as to prevent sucking. 

What is the treatment? A division of the fraenum, 
which should be done carefully, so as to avoid hemorrhage 
and also not to allow the tongue to fall backwards into the 
pharynx, 

Enlarged Tonsils. 

What are the symptoms? A hoarse husky voice, snoring 
during sleep, excessive wheezing when laboring under cold ; 
and upon inspection thoy will bo found to be enlarged. 

What is the treatment? Removal either with the knife, 
or ligature. 

What instruments are used for removing them? Fahnos- 



SURGERY. 



223 



ock's, Physick's instrument modified by Gibson-, and Cham* 
berlin's excisor, the latter of which is to be preferred, 
Elongation of the Uvula* 
What are the symptoms? Irritation about the throat, 
n a as ea, vomiting, and heemoptysis in some cases. 

What is the treatment? Removal with a hook and com^ 
mon scissors, or other suitable instrument. 

Epulis or Tubercle of the Gums. 
What are the symptoms ? It is often a malignant form 
of tumour which sprouts from the sockets of the incisor 
teeth of the upper jaw, or from the gum between the teeth. 

What is the treatment?- Extirpation in its very incipiency 
is the only chance for a permanent cure. 

Diseases of the Neck. 

What diseases aro included under this head? Lodgement 
of foreign bodies in the pharynx, larynx, trachea, and oeso» 
phagus ; stricture of the oesophagus, ulceration of the glottis, 
bronchocele, wry neck, &c. 

Extraneous bodies in the Oesophagus. 

In what manner may extraneous bodies in the cesophagus 
produce death? By producing spasmodic action of the 
muscles of the glottis; from distension of the cesophagus so 
as to press upon the trachea and close it; or by producing 
inflammation or gangrene from the continued pressure; or 
by violent attempts in removing them. 

What is the treatment? When the substance is large it 
generally sticks in the pharynx, from which it may be re- 
moved by the finger, or a pair of forceps. Articles that can 
be digested provided, they have no hard rough points should 
be pushed into the stomach by a probang, unless they can 
be easily reached. Coins, and sharp ragged bodies should 
be extracted by forceps, probang hook, or some other con 
trivance. 

When it becomes necessary to push any of these articles 
nto the stomach puro-atives and mucilaginous draughts 
should be taken. Dr. Physic prescribed rice in large quan- 
tities, for the purpose of defending the coats of the stomach. 

Stricture of the CEsophogus. 

How are they divided? Into spasmodic, and pcrrmmten 



SURGERY* 



which aro sometimes combined. Its most common seat is 
at the commencement of the oesophagus. 

What are the symptoms? Difficulty of swallowing, pain 
in the stomach, nausea, troublesome eructations, and pain 
in the fauces. 

What is the treatment? Bougies, with or without lunar 
caustic. In the spasmodic variety, camphor, opium, and 
ether are serviceable. 

Removal of extraneous bodies from the Larynx and Trachea. 

What operation is performed for this purpose? Laryn* 
gotomy, and tracheotomy. 

The former is the one generally adopted. 

In performing this operation should the incision be made 
at once into the larynx? No; the integuments should first 
be divided, and the hemorfhage entirely stopped; then the 
crico-thyroid membrane may be divided. 

In what other cases are laryngotomy and tracheotomy re- 
sorted to? Sometimes from substances lodged in the oeso- 
phagus, for croup, for enlargement of the tongue and ton- 
sils, ulceration of the glottis, &e. 

Bronchocele or Goitre* 

What is bronchocele? It is an enlargement of the whole, 
or a part of the thyroid gland. Its causes aro not satisfacto- 
rily understood. 

What is the treatment? Iodine, internally and externally. 

Torticollis or Wry Neck. 

What are the causes? Contractions of the platysma my- 
oides, or sterno-cleido-mastoideus, cicatrices of burns, par- 
alysis, &c. 

What is the treatment? When it proceeds from morbid 
contraction of the muscles they should be divided and the 
head brought into a proper position. 

Hernia. 

What is hernia? It is a protrusion of any of the contents 
of the abdomen, covered by peritoneum, through tho pario- 
tes of the abdomen. 

What are the divisions of hernia? Hernia is divided into 
reducible, irreducible, and strangulated. It may also be 



SURGERY. 



225 



ermed from its contents enterccele, epiplocele, and ente= 
ro-epiplocele. 

Reducible hernia is when it is easily replaced. 

Irreducible hernia, when there is permanent protrusion. 

Strangulated hernia, when the parts aie confined by 
stricture. 

Enterocele, when the protrusion consists of intestine. 
Epiplocele, when it consists of omentum. 
Entero-epiplocele, when it consists of intestine and omen- 
tum to^eth^r 

There are also names given from the position they oc- 
cupy. 

Bubonocele, or inguinal henna. 
Oscheocele, or scrotal hernia. 
Merocele, crural or femoral hernia. 
Exomphalos, or umbilical hernia. 

Ventral, when the protrusion occurs in different parts of 
the abdomen without reference to natural op nings. 

Ventro-inguinal, when there is a combination of the two 

What is the sac of a hernia?- It is the peritoneal invest- 
ment which surrounds the protruded viscera. That porti< n 
communicating directly w^ith the abdomen is called its 
mouth; that portion most remote is its fundus; and the rart 
surrounded by the aperture in the tendinous parieties, the 
neck. 

What are the causes of hernia?- The exciting cans' s are 
severe exercise, lifting heavy weights, playing on wird in- 
struments, vomiting, costiveness, coughing, jumping, &c. 

The predisposing are hereditary conformation, and preter- 
natural laxity of the abdominal parieties. 

What are the symptoms of reducible hernia? The tu- 
mour descends in the erect position, and retires by gentle 
pressure, or a recumbent posture. 

It the sac contains intestine its reduction is accompanied 
by gurgling: the tumour will also have a tense, elastic 
feel. Omentum on the contrary, communicates a doughy 
sensation, and is restored to the abdomen with greater diffi- 
culty. Reducible hernia is larger after a meal, and an im- 
pulse is Communicated iO tin finger when the patient is di- 
rected to cough, 

20 ~ 



226 



SURGERY. 



There is generally more, or less disorder of the digestive 
organs. 

What are the causes of a hernia becoming irreducible? 

It may arise from adhesion between the sac and its con- 
tents; from membranous bands; and from extraordinary en- 
largements of the omentum or increase in the volume of in- 
testines. Slow inflammation is the most frequent cause of 
hernia being changed from the reducible to the irreducible 
condition. 

What are- the symptoms of strangulated hernia? In ad- 
dition to the other symptoms of hernia there is obstinate 
ccstiveness, general soreness of the abdomen, pain around 
the navel; sickness of the stomach, and severe pain in tho 
tumour. These symptoms may bo followed by bilious or 
stereoraceous vomiting, hiccup, o^iek, hard pulse, cold 
sweats, and great anxiety of countenance. If relief is not 
obtained the pulse becomes thready, the patient easy, the 
tumour crackle's when pressed upon, and assumes a leaden 
color, enormous distention of the abdomen takes place, the 
pulse becomes fluttering, and death ensues. 

What is the general treatment of hernia? For reducible 
hernia an appropriate truss is the proper-treatment; and the 
patient should never be without one capable of retaining 
the tumour. 

For irreducible hernia a suspension of the tumour by a 
bag truss, and strict attention to diet is all that can be done. 

For strangulated hernia the proper remedies are blood-let-, 
ting, purging, cold, and warm baths, opium, fomentations, 
poultices, cold, the taxis, tart ari zed antimony, tobacco in- 
jections, and an operation. 

Inguinal Hernia, 

Through what openings do tho contents of an inguinal 
hernia pass? Through the internal abdominal ring, inguinal 
canal, and the external abdominal ring. 

Suppose a dissection is made of the coverings and con- 
tents of an inguinal hernia commencing at. the skin, what 
will we find? The integuments, superficial fascia, cremaster 
muscle, hfc^nial sac, omentum, or intestine, or both. 

How is inguinal hernia distinguished from hydrocle? The 
tumor of hernia commences above or at tho external abde- 
mina ring, and descends towards the scrotum; whereas hy- 
drocele commences below, and gradually ascends. 



SURGERY. 



How is it distinguished from cirsocele ? Place the patient 
in a horizontal position, press firmly on the upper part of 
the ring; then direct him to rise; when if it be eirsocele 
the tumour will reappear, with an increase of size: on th.9 
contrary hernia will not show itself until the ringer be re 
moved. 

What 13 meant by concealed inguinal hernia ? It is a 
hernia contained within the canal leading from the internal 
to the external ring. 

In operating for inguinal hernia what parts are divided ? 
The integuments, superficial fascia, cremaster muscle, and 
the sac. 

Where is the seat of stricture in inguinal hernia ? In 
very old and large ones the external ring, but in recent 
cases the internal ring; these strictures should be divided 
upwards in all cases so as to avoid wounding the epigastric 
artery. 

Femoral Hernia. 

Through what opening are" the contents of a femoral her- 
nia protruded } Beneath Poupart's ligament through the 
crural ring. 

How is the ring bounded? On the outer or iliac side by 
the femoral vein; on the inner or pubic side by Gimbemat-s 
ligament; anteriorly by Poupart's ligament, and posteriorly 
by the pubes. 

In dissecting a femoral hernia commencing at the bend 
of the thigh what parts will be presented? The integu- 
ments, superficial fascia, fascia propria, which was origin- 
ally loose cellular membrame occupying the orirlce of the 
crural ring, and the hernial sac. 

What is the treatment? For "reducible an appropriate 
truss. 

For strangulated the treatment must accord with the gen- 
eral principles proper in hernia. 

Where are the points of stricture cf femoral hernia? At 
Hey's ligament, in the crural sheath, at Gimbernat-s liga- 
ment, or at the mouth of the sac. In dividing these stric- 
tures the knife should be turned upward, and slightly in- 
wards in making the incision. If turned outward the cru- 
ral vein and epigastric artery might be injured, or if too far 
inwards the obturator artery may be endangered. 



228 



SURGERY. 



Umbilical Hernia. 

Through what opening do the contents of umbilical her- 
nia protrude] The umbilical ring, either at its centre or 
edges. 

What forms the outer covering of congenital umbilical 
hernial The cellular membrane that connects the vessels 
of the cord; the inner, or sac, is a portion of peritoneum. 

What forms the covering of the protruded viscera of 
young subjects and adults in umbilical hernia] The com- 
mon integuments, superficial fascia, and peritoneal coat. 

What is the treatment] The congenital variety unless 
there is some considerable deficiency of parts or morbid 
complications may be often cured by a bandage; or by redu- 
cing the intestines, and surrounding the sac with a firmly 
drawn ligature so as to produce sloughing, and cause the 
edges of the ring to cicatrize. 

For umbilical hernia of young subjects and adults, a 
properly contrived truss is the proper treatment; or a small 
compress etained in its proper place by a bandage, or adhe- 
sive straps 

For strangulated umbilical hernia 'the usual remedies 
should be used, and if they fail an operation must be re- 
sorted to, 

(Jangenitql Inguinal Hernia. 

In what rospect does congenital hernia diifer from com- 
mon inguinal ] It is do >titute of a distinct peritoneal sac, 
in being lodged in the tunica vaginalis in contact with the 
testicle, and the spermatic cord and artery lie behind the 
hernia. 

What is the treatment] A well contrived truss, and 
when strangulated an operation may be required unless re- 
lieved by the usual remedies. 

Artificial Anus. 

From what does it proceed ] A mortified intestine in 
strangulated hernia; in which case the sound portion ad- 
heres to the neck of the sack, the portion protruded sloughs, 
is thrown off, and the faeces are discharged externally. 

What is the treatment] Nature often affects a cure ; it 
is not best therefore to be too officious in the early stages* 
but simply apply a truss with a broad pad to the opening 



SURGERY 



which will retain the fasces. In this disease the upper 
and lower portion of intestine lie side by side; and a very 
ingenious operation was suggested and practiced success- 
fully by Dr. Physick ; the principle of which is to produce 
adhesion between these two portions, then divide the bar- 
rier between them, and by that means establish a commu- 
nication between the upper and lower portions, and suffer 
the external opening to close. This adhesion was produced 
by passing a crooked needle armed with a ligature within 
tho orifice of one gut and bringing it out at the other, trav- 
ersing in its passage the coats of each, the ends of the liga- 
ture were then tied in a loose loop. 

Diseases of the Rectum. 
Prolapsus Ani. 
What aTe the causes of prolapsus ani or inversion of the 
lining membrane of the rectum? Habitual costiveness, 
straining at stool, diarrhoea, dysentery, hemorrhoids, stric- 
tures, stone, drastic purgatives, &c. * 

What is the treatment? The parts should be returned as 
soon as possible by gentle pressure. If there is much in- 
flammation, bloodletting, general, and local, mild cathartics, 
cold poultices, astringent washes, &c, should first be resor- 
ted to. Where the parts become indurated, and incapable 
of reduction it may become necessary to remove them, either 
with the ligature, or knife. 

Hemorrhoids. 

What are hemorrhoids'? They are tumours situated about 
the rectum, sometimes distinguished as internal, and exter- 
nal, from their situation; blind, and bleeding, according as 
they are attended or not with hemorrhage, 

They may consist of varicose enlargements of veins, or 
from blood poured into cysts formed by cellular membrane, 
or from a more organized growth. 

What is the treatment } To palliate urgent, or present 
symptoms recourse may be had to leeches, cold astringent 
washes, astringent ointments, rest, &c. They may by be 
coming large, and troublesome, or irreducible, require an 
operation, either by the knife, or ligature. When they con- 
sist of varicose enlargements the ligature should always bo- 
used; on the contrary in the other kinds tho knife may be 
proper. 



530 



SURGERY. 



Fistula in Am. 

What is fistula in ano? It is an abscess about the verge 
of the anus with one or more small epenings. If the open- 
ing communicates with the rectum and not with the integ- 
uments it is called internal fistula; if it opens upon the sur- 
face of the integuments it is an external fistula; and if there 
is an opening both internal and external it is called a com- 
plete fistula. 

What is the treatment] Absoluto rest, moderate diet, 
and mild laxatives. 

When the disease is long established an operation be- 
comes necessary, unless consumption exists, in which case 
the fistula ought not to be healed. 

Diseases of the Testicle and Penis. 

Hydrocele. 

What is hydrocele 1 It is a collection of water in the tu- 
nica vaginalis; and forms an elastic pyriform tumour which 
at first occupies the lower part of the scrotum, and gradual- 
ly extends upwards. 

What is the treatment? An operation is generally re- 
quired; and is either palliative, cr radical. 

The palliative operation is simply the evacuation of the 
fluid by a lancet, or small trocar. 

The operation lor radical euro may bo performed by lay- 
ing opon the tunica vaginalis ; by passing a seton through 
it; by applying caustic; by extirpating a part of the tunica 
vaginalis; by tho introduction of a tent; and by injection 
after the water has been evacuated. 

The latter operation is the one usually performed, and ge- 
nerally with success when properly done. There are sever- 
al different articles made uso of for tho purpose of injection. 

Hematocele. 

What is hematocele? It is a collection of blood, either 
in the tunica vaginalis testis, within the tunica albuginea, 
or in the cellular membrane of the scrotum. It may proceed 
from injury of one cr more of the blood vessels of tho scro- 
turn. , 

What is the troatment? If the extravasation is small it 



SURGERY. 



will probably bo absorbed in a short time. If it is not, aa 
incision should be made* and the blood evacuated. 

Phymosis. 

What is phymosis ? It is where the prepuce is contracted 
in front, and cannot be drawn over the glans penis. 

There are two varieties; the natural when it exists at 
birth; and the preternatural when it occurs at any other pe~ 
riod of life. 

What is the treatment? An operation; either by slitting 
up the prepuce, or removing a small portion by circumci- 
sion. 

In preternatural, when attended with high inflammation 
the best remedies are local bleeding, emollient poultices, 
fomentations, &c. 

F tr a phymosis* 

What is paraphymonis 1 It is where the prepuce is firm- 
ly retracted behind the corona, leaving the glans penis un- 
covered, and sometimes producing great constriction and 
swelling. It may be congenital or acquired. 

What is the treatment? Cold, the antiphlogistic course, 
and steady pressure kept up for several minutes. In ex- 
treme circumstances the stricture must be divided. 

Diseases of the Urethra and Bladder, 

Stricture of the Urethra, 

How are they divided} into permanent, spasmodic, and 
a. combination of the two. 

What part is the common seat of stricture? Usually be- 
hind the bulb about seven inches from the extremitv of tho 
glans; also at the distance of four or five inches; and three 
and a half inches; sometimes the orifice itself is the seat of 
stricture. 

What aie the symptoms? The constitutional symptoms 
are disorder of tho digestive functions, general irritability, 
severe chills, followed by high fever, and profuse perspira- 
tion; tho febrile paroxysm is not however an invariable at- 
tendant. 

The local symptoms arc a slight discharge of matter from 
the urethra, a frequent desire to urinate, tho urine issues in 
drops or in a forked, twisted, wiry* or thread like stream 4 



232 



SURGERY. 



nocturnal omissions, scalding of tho urine, &c. Excoss in 
eating, drinking, and cold, aggravate all those symptoms. 

What is the treatment? The first object is to ascertain 
the position and extont of the stricture; which may be done 
by a bougie, catheter, or urethra sound. 

There are three methods of cure. Dilatation by bougies; 
destruction by caustics, and division by a stilet. 

Fistula in Perinaeo. 

What is fistula in perinaeo? It is an abscess communi" 
eating externally, and with the urethra internally. It may 
proceed from strictures of the urethra, or from blows or 
other injuries. 

What is tho treatment? If it depend upon stricture tho 
^first indication is to get rid of that; if the canal anterior to 
lie fistula becomes obliterated it can only be accomplished 
by an operation. When the fistula is pervious it should bo 
dilated with bougies, or such other means as tho case may 
require. 

Retention aud Incontinence of Urine. 

What are tho causes of retention of urine? Severe gon- 
orrhoea, strictures of the urethra, enlarged prostate, spasm 
of the neck of the bladder, stone, hemorrhoids, fistula in 
ano, stimulating diuretics, blisters, &c. 

What are the remedies for retention of urine? Tho 
warm bath, blood-letting, purgatives, opiate enemata, the 
catheter, forced injections to overcome obstructions, and 
puncture of the bladder. When it is necessary to punc- 
ture the bladder it should bo done either through tho peri- 
neum, above tho pubos, or through the rectum; tho opera- 
tion of puncturing above tho pubos is tho one generally per- 
formed. 

What is the treatment for incontinence of urine? The 
nternal use of cantharides, muriated tincture of iron, bark, 
opium, cold bath, and blisters, either singly or conjoined in 
such manner as may bo indicated. 

Urinary Calculus. 

Where are urinary calculi found? In tho kidney, ureter, 
bladder, prostate gland, or urethra, but they are mostly 
found in the bladder. 

What are the symptoms of stone in tho bladder? Fre- 



SURGERY. 



233 



quent desiro to make water, and severe pain on voiding the 
last drops of it; sudden stoppage of the urine while passing, 
and flowing again frequently by change of posture, and 
tenesmus. Sounding is however the only positive symptom, 
and should always be done before a course of treatment is 
adopted. 

What is the treatment for urinary calculus] When there 
is a calculus passing the ureter decisive treatment should be 
adopted. Blood should be drawn freely if the patient is 
robust, and a brisk purge given, the warm bath and spirits 
of turpentine, or spirits of turpentine and opium may be 
used with benefit; the tincture of the poke berry juice has 
also been recommended. When the bladder contains a 
stone the operation of lithotomy, lithotrity, or lithotripsy 
must be performed. 

Amputation. 

W r hat are tho injuiies for which amputation is resorted 
to! Gun shot wounds and fractures, mortification, tumors, 
diseased joints, and ulcers. 

What circumstances influence us in regard to the propri- 
ety of amputation in gun shot wounds and fractures? When 
the chief arteries of a limb are divided, the muscles lacer- 
ated, and the bones badly broken amputation should be per- 
formed; also when complicated with severe injury of tho 
joints. 

W T hat tumours may render amputation necessary ? Osteo- 
sarcoma, spina ventosa, exostosis, fungus haematodef, &c* 



PART V. 



— OBSTETRICS. 



The Pelvis. 

Where is the pelvis situated, and of what is it composed? 
It is between the last lumbar vertebra and the superior ex- 
tremities of the thigh bones. 

It is composed of four bones in the adult; on its posterior 
and inferior parts by the sacrum and coccyx; and on its lat- 
eral, inferior, and anterior parts by the ossa innominata. 

What are the characteristics of the Sacrum? It was ori- 
ginally composed of five pieces — its figure is triangular, 
with the base upwards; has four surfaces, an anterior, pos- 
terior, and two lateral; and is pierced by four holes on each 
side for the passage of the sacral nerves. Superiorly it is at- 
tached to the last lumbar vertebra, and laterally to the ossa 
innominata. Its length is from four to four and a half inches, 
breadth about four inches, and the depth of its concavity is 
about three-fourths of an inch. 

What are the characteristics of the Coccyx? It is H inch- 
es in length, pyramidal, has its base upwards, articulates 
with the sacrum, and is composed of three or four bony 
portions. 

What are the characteristics of the Ossa Innominata? 
They are on each side, divided into three portions which 
were originally distinct; the ilium, ischium, and pubes. 

The ilium on each side forms the highest lateral portion 
of the pelvis; the superior edge is nearly semicircular, tip- 
ped with cartilage, and called tho spine; the external sur- 
face is convex, and called tho dorsum; tho internal is con- 
cave, and called the fossa. It has two anterior, and two 
pi sterior spinous processes, forms with the os pubis tho 



OBSTETRICS. 



235 



linea ileo-pectinea, and with thopubes and ischium the ace- 
tabulum. 

Tho ischium is the lowest of the throe bones, on each 
side; it terminates in a tuber below from which a process 
runs upwards to join the pubis. 

Tho pubis is the smallest of tho three; its longest portion 
forms a part of the acetabulum; it then diminishes in size, 
stretches over to join its fellow of . the opposite side, and 
sends a branch downwards to unite with a portion of 
tho ischium in such manner as to leave an opening, the for- 
amen ovale. 

Tho innominata are joined posteriorly to the sacrum by 
cartilages and appropriate ligaments: the anterior junction 
is called the symphysis of the pubes. 

Where are the Saero sciatic ligaments situated ? The pos- 
terior arises from the posterior inferior spinous process of 
the ilium, from the lower margin of the sacrum, and from 
the first bone of the coccyx; is inserted into the internal 
margin of the tuberosity of the ischium, and is extended 
along the internal face of the crus. 

The anterior is placed in front, and arises from the mar- 
gin of the lower part of the sacrum, and the lateral margin 
of the coccyx; the fibres converge and are inserted into tho 
spinous process of the ischium. This is the arrangement on 
each side of the pelvis. 

How is the pelvis divided? Into the large and small, or 
false and true ; or the pelvis above and below the brim: — 
The line of demarcation being the linea ileo-pectinea at 
the sides, the crista onf the pubis in front, and the promonto- 
ry of the sacrum behind. 

What is the distinction between the male and female pel- 
vis! The male pelvis has a contracted brim of a rounded 
form or triangular shape, with the promontory of the sac- 
rum projecting. The female pelvis is spacious, of an oval 
shape, with the sacrum slightly prominent, and greater 
space is afforded for the passage of * the child. The cavity 
of the male pelvis is deep, while in the female it is shallow. 

In the male there is a contracted angular arch of the pu- 
bes; in the female there is a spacious and well rounded 
arch, and the tuberosities of the ischia -are much wider 
apart. The length of the sacro-sciatic ligament, and the 
mobility of the coccyx upon the sacrum serve also to distin- 
guish the female pelvis-. 



OBSTETRICS. 



What are the parts of the pelvis the diameters of which 
are important? The brim, cavity, and outlet. 

What are the superior and inferior openings sometimes 
called? The superior, and inferior straits. 

What are the diameters usually measured of the brim, 
eavity and outlet? 

The straight or antero-posterior; the transverse; and the 
oblique. 

What are the measurements of the brim or superior strait? 
The antero-posterior from the promontory of the sacrum to 
the symphysis is 4.3 inches; the transvere from the middle 
of the linea ilio-pectine of one ilium to the other is 5.4 
inches ; and the oblique from one sacro-iliac symphysis to 
the acetabulum opposite is 4.8. 

What are the measurements of the cavity? The antero 
posterior frem the centre of the hollow of the sacrum to 
that of the symphysis is 4.8 inches; the tmnsverso from tho 
point corresponding to the lower margin of the acetabulum 
on one side to that of the other is 4.3 inches; and the ob- 
lique drawn from the centre of the free space foimed by the 
sacro sciatic notch and ligaments on one side to the for- 
amen ovale of the other is 5.2 inches. 

What are the measurements of the outlet or inferior 
strait? The antero-posterior from tho point of the coccyx 
to the lower edge of the symphysis pubis is 3.8 inches but 
during labor tho mobility of the coccyx may allow this 
diameter to bo increased one inch, or to 4.8 inches; the 
transverse from one tuberosity of the ischium to the other is 
4.3 inches ; and the oblique from the middle of the lower edge 
of the sacro-sciatic ligament of one side to the point of 
union between tho ischium and descending ramus of the 
pubes on the other is 4.8 inches. — Rigby 

What is meant by the axes or the pelvis? They are lines 
drawn at right angles with the planes of the straits through 
their centres. 

What relation does the axis of the superior strait boar to 
tho horizon? It forms an angle between 50° and 60°. A 
line drawn from the umbilicus to the point of the coccyx 
will represent the axis of the superior strait. 

W^hat is meant by tho inclination of the pelvis? The 
s -nglfc which the axis of the superior strait forms with the 
horizon when a woman is in the upright position marks 
what is called the inclination of her pelvis. 



OBSTETRICS, 



237 



What relation does the axis of the inferior strait bear to 
the superior? It forms with it nearly a right angle; and is 
represented by a line drawn from the sacrum just below tho 
promontory perpendicular to the plane of the inferior strait, 
The angle" which the axis of one strait forms with the hori- 
zon is inverse to that of the other. 

What is the shape of a line that will represent tho axis of 
the pelvis? It will be a curved line, the shape of a male 
catheter passing through the centre of a series of planes ex- 
tending from the sacrum to the pubes, from the linea-ileo« 
pectinea to tho coccyx and sub-pubic ligament. 

"What is the arrangement of the two lateral inclined 
planes within tho pelvis on each side? They are divided 
into anterior and posterior. 

The anterior commences near the sacro-iliac symphysis, 
extends to the symphysis pubis, passes downwards and for- 
wards in front of the spine of the ischium, and over tho 
obturator foramen, terminating on the anterior edge of the 
ramus of the pubis and ischium. 

The posterior commences at tho sacro-iliac junction, ex- 
tends to the middle line of the sacrum, passes downwards 
and backwards behind the spine of the ischium over the 
sacro-sciatic foramen, and sacro-sciatic ligaments, termina- 
ting on the posterior edge of the tuberosities of the ischium, 
the lower edge of the sacro-sciatic ligament, and point of tho 
coccyx. These planes influence the presenting part of the 
foetus; when the occiput is brought in contact with the pel- 
vis anterior to the spine of the ischium, it will pass down 
upon the anterior inclined plane, and emerge under the arch 
of the pubes; but if it enter the pelvis behind the spine of 
the ischium, it will pass down the posterior inclined plane, 
rotate into the hollow of the sacrum, and emerge at tho 
posterior commissure of the vulva, 

Of Deformity of the Pelvis. 

What is meant by a deformity of the pelvis? Any devi- 
ations from its healthy dimensions, either by excess or di- 
minution. 

What are the evils arising from an excess in size? Pre- 
cipitation of the uterus within the pelvis durinof gestation, 
with its consequences; and during parturition~a"too rapid 
labor, which may cause alarming hemorrhage. 

What are the remedies for the difficulties arising from an 



OBSTETRICS, 



excess in size* For the first, a proper sized pessary, or a 
utero-abdominal supporter. 

For the second, forbidding the woman to bear down during 
labour; opposing the too rapid escape of the child by pres- 
sing on its head, or the perineum of the mother, and hemor- 
rhage may be much diminished by brisk frictions on the 
abdomen over the uterus, and by ergot. 

What are the usual causes of distortions of the pelvis'? 
Rachitis in infancy, and melacosteon in old age. 

What portion is generally distorted? The upper strait; 
and this in its antero-posterior diameter; when the inferior 
strait is distorted it is generally in its transverse diameter, 
by the approximation of the tubers of the ischia. 

There is not however any portion but "what is liable to 
deviation from its healthy measurements. 

What is the smallest antero-posterior diameter of the su- 
perior strait that will allow a labor to be terminated suc- 
cessfully? Thi v e inches; if there is even three and a half, 
labor is rendered tedious, painful, and uncertain. 

In what position would you keep a child affected with 
rickets, to prevent deformity of the pelvis? In a horizontal 
one, and permit it to exercise its limbs freely upon a bed or 
matrass. 

To what other deformities is the pelvis liable? Exostoses, 
and tumors. 

What are the means proposed for measuring the p. Ivis? 
The pelvimeter, intro-pelvimeter, caliper, by the introduc- , 
tion of the finger agains* the most projecting part of the 
base of the sacrum, and by the introduction of the hand, in 
time of labor, and placing the fingers edgewise between 
the posterior part of the symphysis and the projection of 
the sacrum. The finger and the hand are most to bo 
depended upon. 

Of the Childs Head. 

What are tho principal diameters of the childs head? 
The oblique, from tho symphysis of tho chin to the posteri- 
or ?nd superior extremities of the parietal bones, or the pos- 
terior extremity of the sagittal suture measuring 5 inches; 
the longitudinal from the centre of the forehead to tho top 
of tho lambdoidal suture measuring 4 inches ; the perpen- 
dicular, from the summit of the hoad to the base of the era 
nium measuring from 3 to 3£ inches; and tho transverse, 



OBSTETRICS. 



239 



from one parietal protuberance to the other measuring from 
3 to 3i inches. 

Are these diameters ever altered during the progress of 
labour?* They are liable to be from the suppleness of the 
bones of the head of the foetus: but all cannot be diminish- 
ed or increased at the same time: if one is diminished ano- 
ther must be increased. The extent to which these changes 
may take place varies in individual cases owing to the more 
or less perfect ossification of the bones. 

What are the sutures of the foetal head ? The sagittal or 
the line of union from the occipital bone to the root of the 
nose,, connecting the parietal and the two sides of the fron- 
tal bone with each other: the coronal which connects the 
anterior portions of the parietal and the posterior portions of 
the frontal bone: the lambdoidal which connects the poste- 
rior portion of the parietal and the anterioi portion of the 
occipital bones. 

What forms the anterior fontanelle, and how is it distin- 
guished? It is formed at the points of decussation of the 
sagittal and coronal sutures. It is distinguished by four 
bony angles, the edges of which are tipped with cartilage, 
and are smooth, s:>ft, and yielding. 

What forms the posterior fontanelle, and how is it distin- 
guished ? It is formed at the points of junction of the pos- 
terior end of the sagittal with the centre of the lambdoidal 
suture, and has three bony angles; two by the parietal, and 
one by the occipital bones. 

What parts of the head are of most importance to under- 
stand in order to determine the presentations} The sutures, 
and fontanelles. 

To what extent may 'the head be rotated on the trunk 
with safety to the child? One quarter of a circle, and not 
more. 

Of the Gexital Organs. 

How are the organs of generation, and parts concerned in 
delivery divided? Into internal, and external. The exter- 
nal consists of the mons veneris, labia, clitoris, nymphae, 
meatus urinarius, hymen, orifice ot the vagina, caruncula 
myrtiformes, fraenum labiorum, fourchette, fossa navicularis, 
and perineum. 

The internal are the uterus, fallopian tubes, ovaria, liga* 
mcnts, and vagina, 



£40 OBSTETRICS. 



Where is the mens veneris and the other external organs 
situated? The mons veneris is an accumulation of cellular 
and adipose membrane covering the pubes. 

The labia are two bodies of a similar texture to the mons 
veneris, running parallel from it in a downward and back- 
ward course. 

The clitoris is directly beneath the superior union, or ori- 
gin of the labia ; it consists of two crura which unite and form 
its body, the external termination of which has been called 
its glans. 

The nymphoe are two similar bodies depending from the 
clitoris, which separate and run downwards towards the os 
externum. 

The orifice of the urethra is found between the inferior 
portions of the nymphse. The canal of the urethra is about 
\k inches in length. 

The orifice of the vagina is below the orifice of the ure- 
thra, and immediately under the symphysis pubis. 

The hymen is a membranous expansion at the orifice of 
the vagina, and partially closing it. 

The caruncula myrtiformes are small fleshy vascular bo- 
dies situated at the external orifice of the vagina upon 
which in the virgin state the hymen appears to spread itself. 

The fourchette is a semilunar fold in advance of the hy- 
men. 

The fossa navicularis is between 'the hymen and four- 
chette. 

The perineum is the space directly behind the inferior 
termination of the labia and before the anus, about an inch 
and a half in width. 

Where is the vagina situated? It is a dense elastic canal, 
lined with mucous membrane which leads directly from the 
externa] organs to the uterus; its course is a little down- 
wards and then upwards; and the length is from 4 to 6 in- 
ches. The mucous membrane is thrown into folds or rug8B 9 

Where is the Uterus situated, and wLat are its character- 
istics? In the cavity of the pelvis, at the upper extremity 
of the vagina with the bladder in front, and the rectum he^ 
hind. It is 2£ inches long of a pear shape, a little flatten- 
ed, wath its small extremity hanging into the vagina. It is 
divided into fundus, body, and neck. 

The fundus Is that portion above the origin of the fallopi- 
an tubes; the body is the part extending from thein below 



OBSTETRICS. 



241 



to the commencement of the neck; and the neck is that ac- 
uminated portion which dips into the vagina, and termi- 
nates in the os tincae. Its structure is muscular, and the in- 
ternal cavity is triangular, and lined by a fine membrane 
which secretes the menstrual fluid. 

Where are the Fallopian tubes situated? They are con- 
nected with the uterus on each side at a line which would 
divide the fundus from the body. They are tortuous hollow 
bodies 4 or 5 inches long, with the uterine extremity small, 
and terminating at the other extremity in an opening of 
some capacity, which is surrounded by an uneven frill call- 
ed the fimbria. 

Where are the Ovaries situated? They are two small, 
roundish bodies about the size of a nutmeg, near to the ab~ 
dominal extremities of the fallopian tubes, in the folds of 
the lateral or broad ligaments, one on each side, and are 
the seat of conception. 

What are the ligaments of the uterus? The broad; the 
anterior or round; and the posterior or utero-sacral liga- 
ments* 

Where are they situated? The broad ligaments are du- 
plicatures of the peritoneum as it passes from the uterus to 
the lateral portions of the pelvis, one on each side. 

The anterior or round ligaments arise from the superior 
and lateral part3 of the uterus, run in the doublings of the 
broad ligaments, pass over the brim of the pelvis, through 
the abdominal rings, and loose themselves in the groins. 

The posterior ligaments arise from the posterior portion 
of the neck of the uterus near its middle, diverge and as- 
cend towards the middle of the lateral edges of the sacrum, 
and are lost in the cellular membrane covering that bone. 

What arteries supply the uterus with blood ? The sper- 
matics, and hypogastrics. 

The nerves are supplied from the intercostal, the renal 
plexus, and the sacral. 

Menstruation. 

What is meant by menstruation? It is that function in 
which the uterus periodically secretes a sanguinolent fluid. 

What part gives origin to this secretion ? The internal 
coat of the uterus. 

What are the characteristics of this secretion? It 

21* 



OBSTETRICS. 



resembles blood, has a peculiar quality and odor, it is not 

coagulable, nor does it putrify readily. 

At what period does menstruation take place? It takes 
place at puberty, or that period at which the animal is ca- 
pable of propagating its species; the age varies under the 
influences of climate, constitution, and modes of life ; earli- 
er in hot than cola countries, sooner in cities than in the 
country, <xc. 

What are the symptoms which precede menstruation? 
The mammae increase in size, the voice is changed, the pu- 
bes are covered with hair, the best proportions are. develop- 
ed, and the mind is rapidly matured. 

Besides these there is headache, dullness of the eyes, 
pains in the pelvic region, lassitude, whimsical appetite, 
leucorrhea, &c, which gives place to a discharge from the 
vagina. 

What is the menstruous period-? From four to six days; 
and during; this time from four to six ounces of fluid are 

discharged. 

What are general symptoms during the menstrual flow? 
The appetite becomes capricious, the person is languid, pale, 
or hectically florid, dark under the eyes, and frequently 
there is a dragging sensation Rbout the hips and loins. 

At what age does it cease? From forty-five to fifty. In 
this climate at about forty-six or seven. 

Does the regular appearance of the menses every twenty- 
eight days indicate a capability for procreation or reproduc- 
tion? It does. 

Is the uterus influenced by any of its appendages in this 
function? The ovaries appear indispensible to it; as their 
absence either natural, or by removal prevents the appear- 
ance of the menses 

Is menstruation a physiological or a pathological condi- 
tion? It is strictly a physiological function. 

Is the cause of menstruation well understood? It is not; 
there have been many theories formed to account for it, but 
they are not satisfactory. 

Derangement of the function of Menstruation. 

To what derangements is this function liable? To a too 

tardy appearance of the menses. 

To its interruption after having been established. 
To excess of quantity. 



OBSTETRICS. 



243 



To monorrhagia. 

To dysmenorrhea or painful menstruation. 

And to irregularities towards the decline of life. 

At what period of life in this country does menstruation 
take place? From the fourteenth to the fifteenth year. 

Does age of itself present an indication for interference in 
regard to this function? No; there should be other eviden 
ces of womanhood ; and when these are absent the girl should 
never be tortured by emmenagogues. These signs are enu- 
merated under the head of menstruation. 

What should be done where these signs to a greater, or 
less extent exist, and menstruation does not appear, with 
a delicate state of health cf the patient? There should 
be a regular course of exercise instituted when the patient 
can bear it; such as riding on horseback, walking, skipping 
the rope, &c. The dress should be attended to; and the diet 
should consist of easily digested food, both animal, and veg- 
etable; all stimulating drinks should be avoided. Tincture 
of cantharides particularly if leucorrhoa attends may be giv- 
en in doses of thirty .drops three times a day. Keeping the 
bowels regularly open with aloetic pills with or without the 
sulphate of iron is beneficial. 

What is to be done when a chronic disease exists? At- 
tention should be given to the disease when we have reason 
to suppose the absence of the menses depends upon it. 

What is understood by suppression of the menses? It is 
the want of return of this discharge at the accustomed peri- 
od after it has been established, when not interrupted by 
pregnancy, or suckling. 

What are the causes? Cold, applied either in the inter- 
val, or during the flow. 

What are the symptoms? Paleness, emaciation, debility, 
nervous -symptoms, palpitation of the heart, difficulty of 
breathmq , and a disturbance of the circulation, to which 
may be a J edfluor albus, and more or less pain in the loins 
and pelvis. 

Wnatis the treatment? It will depend upon the state of 
the circulation; if the pulse is disturbed we should prescribe 
blood letting, purging, low diet, &c, until it is corrected; 
and then we can safely give emmenagogues; among these 
aloetic and ferruginous pills, and the ammoniated tincture 
of ^uiacum stand first. 

What is understood by dysmenorrhea? It is a menstruous 



244 



OBSTETRICS. 



discharge accompanied by pain of a forcing and bearing 
down kind, and a discharge of a membranous substance or 
coagula. 

What is the treatment] During the paroxysms the pain 
should be relioved by anodynes, and antispasmodics, such 
as camphor, and camphor and opium, with perfect rest. In 
the intervals use alteratives and tonics aiter proper deple- 
tion. 

Pregnancy. 

What changes take place after the period of impregna- 
tion? The ovum increases in size and is prominent on the 
ovarium, absorption of its peritoneal coat takes place, it is 
embraced by the fimbriated extremity oi the fallopian tube, 
and carried towards the cavity of the uterus. 

At what time is the ovum found in the uterus? About 
twenty days after impregnation. 

What is the appearance of the ovarium after the ovum is 
removed? First an effusion of blood into the cavity from 
whence the ovum was removed, and this is followed by a 
corpus luteum. 

The Membranes. 

What takes place during this time in the cavity of the 
uterus? The internal surface throws out a vascular tissue 
which is termed the membrana decidua; it lines the cavity 
of tho uterus down to the internal os uteri, remains next 
to it during pregnancy, and forms the medium of contact 
between the uterus and the ovum. 

What are the membranes of the ovum? There are two; 
the chorion externally, and the amidon internally. They 
enclose the embryo and the water in which it floats. 

What takes place when the ovum arrives at the uterus? 
The ovum adheres to the decidua and causes a growth of 
that part with which it comes in contact, and is called the de- 
cidua reflexa; so that the decidua is then divided into that 
portion lining and in contact with the uterus called decidua 
vera; and that portion in contact with the ovum, and called 
decidua reflexa; this arrangement corresponds with that 
of the pleura pulmonalis and costalis; they come in contact 
about the fourth month. 

What are the uses of the amnion and chorion? The am- 



OBSTETRICS. 



245 



nion furnishes a quantity of fluid for the protection of its 
contents; the chorion furnishes a means of communication 
with the uterus, and is thought by some to form the basis of 
the placenta. 

What then does tho ovum consist of after its establish- 
m< nt within the uterus? The decidua, decidua reflexa, 
chorion, amnion, liquor amnii, foetus, and umbilical cord, 
with one extremity attached to the umbilicus of the child, 
and the other to the membranes, which for the present an- 
swers the purpose of the placenta. 

What are the uses of the liquor amnii? Perhaps its uses 
are not entirely known; but it allows space, and facilities 
for motion, development, &c, of the foetus. 

What composes the umbilical cord? It consists of two 
arteries, a vein, a layer of amnion, and perhaps also of the 
chorion; the arteries are a continuation of the primitive 
iliacs; the vein passes under the edge of the liver, and en- 
ters the vona cava. 

The Placenta, 

What is the placenta and its characteristics? It is that 
vascular mass by which the circulation is maintained be- 
tween mother and child, and the latter is nourished. Its 
diameter is six or eight inches, and its thickness is from a 
few lines at its edge to one inch or more at its centre. It 
has two surfaces; the uterine which is rough, spongy, trav- 
ersed by sulci, and it is believed by many that the decidua 
lines its whole surface; and the foetal which is smooth, and 
lined by the amnion. 

What kind of communication exists between the uterus 
and placenta? It is by capillary veins and arteries. 

Suppose an injection passed into the umbilical arteries 
what becomes of it? It passes into the veins of the pla- 
centa, and the whole plexus may be filled. The arteries 
may be filled in the same manner by injecting the umbilical 
vein. 

What is meant by embryo? It is the new being during 
the first three months of gestation; the balance of its intra- 
uterine existence it called foetus. 

The Foetal Circulation. 

What are the peculiarties of the circulatory apparatus of 
the foetus? There are five: 1st. The vena umbilicalis. 2d. 



246 



OBSTETRICS. 



The ductus venosus. 3d. The foramen ovale. 4th. The 
ductus ateriosus. 5th. The arteries umbilicales. 

What is the vena umbilicalis? It arises from the placenta, 
enters the abdomen through the naval, passes along the an- 
terior margin of the suspensory ligament of the liver, is 
connected with the sinus of the vena portarum, and a great 
portion of its blood is distributed to the liver. 

What is the ductus venosus ? It arises from the vena por- 
tarum, and empties into the left hepatic vein near its junc- 
tion with the vena cava; it arises directly in face of the 
umbilical vein, so^that a probe may pass readily from one to 
the other. 

What is the foramen ovale? It is a large aperture be- 
tween the two auricles of the heart, finished with a valve, 
which closes when respiration begins. 

What is the ductus arteriosus? It is a canal leading from 
the pulmonary artery into the aorta, and discharges into the 
aorta at the lower part of the curvature. 

What are the arteria umbilicales? They are two in num- 
ber, and are a continuation of the external iliacs; they pass 
through the navel in company with the umbilical vein, twist 
spirally around it, and are distributed to the placenta. 

What is the course of the fcetal circulation ? It is from 
the placenta through the umbilical vein and ductus venosus 
into the ascending cava, which discharges the blood into the 
right auricle of the heart. The eustachian valve turns, the 
greater part of the blood into the left auricle, through the 
foramen ovale. The left auricle may then be said to be dis- 
tended with blood from the ascending cava, while the right 
is distended with the blood of the descending cava,. The 
auricles contract together and fill the ventricles. The ven- 
tricles also contract together, and fill the pulmonary artery 
and aorta. The blood of the right ventricle having got into 
the pulmonary artery is principally discharged by the duc- 
tus arteriosus into the descending aorta. That of the left 
side by being driven into the aorta is mostly sent through 
the arteria innominata, the left carotid, and the left subcla- 
vian, to the head and upper extremities; what remains being 
mixed with the contents of the descending aorta, goes to 
the lower extremities; but by far the greater portion of the 
blood of the descending aorta passes through the umbilical 
arteries to the placenta, where it is rendered fit for the nu- 
trition of the foetus, taken up by the umbilical veins, and 
repeats the same round until respiration is established. 



OBSTETRICS. 



247 



Changes in the Uterus from Impregnation. 

What are the changes which take place in the parietes of 
the uterus itself from impregnation? There is an increas- 
ed quantity cf blood sent to it which increases with ges- 
tation ; the vessels from being small and convoluted become 
enlarged and straighter. 

The fibres of the uterus become developed so as to be re- 
cognized as muscular; the organ increases in size with per- 
fect regularity, and its position and distension give us a 
pretty accurate knowledge cf the advancement of pregnan- 
cy. 'For the first three or four months the uterus is found 
lower in the vagina than when unimpregnated ; after the 
fourth or fifth month the fundus can be felt at the pubic re- 
gion; at the sixth half way between it and the umbilicus; 
at the seventh at the umbilicus; at the eighth half way be- 
tween the umbilicus and the scrobiculus cordis; at the ninth 
about the same owing to the more perfect development oi 
the neck. The neck of the uterus undergoes changes also 
after the sixth month; it becomes shorter and shorter, and 
at the ninth month it is entirely obliterated; furnishing, then 
the principal increase of space for the fcetus. Of the body 
and fundus, the posterior portions contribute the most space, 
and hence the fallopian tubes at the latter part of pregnancy 
are found in advance of the uterus. 

Of the developement of the Fosius. 

In what order is the product of conception developed? 

To the fifteenth day it is a gelatinous, semitransparent, 
flocculent, greyish mass; at thirty days it is the size of a 
large ant, varying from three to five lines in length; at six 
weeks it is ten lines in length, about the size of a bee, and 
some of the rudiments of organs are visible ; at two months it 
is about two inches long, the weight is two ounces, and os- 
sification has commenced in some parts; at the third month 
it is about three and a half inches long and weighs nearly 
three ounces, the umbilical cord is formed, and the genital 
organs are distinct; at the fourth month it is from five to six 
inches long, and weighs from four to five ounces. 

During the fifth month motion is perceptible by the 
mother, the length i-5 from seven to nine inches, and the 
weight nine or ten ounces; at the sixth month the parts are 



S4B 



OBSTETRICS. 



more perfectly developed, it weighs from one to two pounds, 
and its length is from nine to twelve inches. 

At the seventh month all parts are more perfectly devel- 
oped; the eye lids which until now have been united by the 
membrana pupillaris are separated ; the hair and nails grow, 
the weight is from iwo to three pounds, and the length is 
from twelve to fourteen inches. At eight months the weight 
is from three to five pounds, the length sixteen inches or 
more, and all the parts show a much more perfect condition 
of developement. At the ninth month the head has 
considerable firmness, ossification is more complete, all the 
organs tire capable of performing their appropriate func- 
tions in a more perfect manner; the length of the foetus is 
about 20 inches and the average weight is about 7 pounds in 
this country. 

Extra-uterine Pregnancy. 

What are the varieties of extra-uterine pregnancy? Ova 
rtan pregnancy, or when the embryo is developed in the 
ovary. 

Ventral or abdominal pregnancy, wnen the embryo be- 
comes deposited and developed in the cavity of the abdo- 
men. 

Tubal pregnancy, or when the embryo becomes devel- 
oped in the tube. 

Interstitial pregnancy, or when the ovule becomes de- 
posited between the layers of the muscular fibres of the uto- 
rus and is developed. 

What are the consequences of extra-uterine pregnancy? 
The consequences are usually serious; irritation, inflamma- 
tion, suppuration, ulceration, internal hemorrhage, and 
sloughing are all liable to happen, and often to the extent 
of causing death to the mother. 

What is the proper treatment? Generally a palliative 
treatment is the best. 

Gastrotomy has been recommended by some authors. 

Of the signs of Pregnancy. 

How are the signs of pregnancy divided? Into the ra- 
tional or sympathetic, aud the positive or physical signs. 

What are the rational signs of pregnancy? Suppression of 
the menses; the nipples and papilla become enlarged, tumid, 
dark colored, and surrounded by an areola; morning sick- 
ness; enlargement of the abdomen, &c. 



OBSTETRICS. 



249 



Are these signs positive'? No; they are all fallacious 
and mav be produced by other causes than pregnancy. 

What is the mode of examination to detect the physical 
signs? The examination of the abdomen by tha hand, by 
auscultation, and ballottement. 

What do we detect by an examination of the abdomen 
with the hand? The form of the tumour, and the move- 
ments of the foetus. 

What mav be detected by ause illation 1 The pulsations 
of the fcetal "heart, and the uterine souffle, and to these may 
be added the movements of the foetus. 

Is the uteiine souffle a sign to be invariably relied upon ? 
No; it is valuable, but not conclusive. 

Are the pulsations of the foetal heart to be relied upon? 

They are conclusive when heard; which can almost in- 
variably be done when pregnancy exists, after the fourth 
month, although at this early period great care is required. 
The point where it may often be heard is about midway 
between the scrobiculus cordis and symphysis pubis, or per- 
haps more frequently a little to the left of the middle hue. 
These pulsations may be distinguished by their quickness, 
which are from 130 to 150 in a miuute. In cases of double 
pregnancy the] sound of both foetal hearts may mostly 
be heard in the last weeks of pregnancy. 

What is meant by ballottement, and" what is its impor- 
tance as a diagnostic of pregnancy? The process of bal- 
lottement is performed by passing the finger to the mouth 
of the uterus, or midway between it and the symphysis pu- 
bis, while the other hand is applied upon the abdomen to 
the fundus; the finger should be suddenly pushed up against 
the uterus, while the palm of the other ban I is piaced on 
the abdomen to receive any impression which such a shock 
may produce, the finger in the vagina is to be kept applied to 
the uterus, so that it may determine whether any floating 
body descends upon it. By these means we can determine 
whether the uterus contains a floating body, but it does not 
give us absolute knowledge of what that floating body 
consists. The woman should be in the erect position. 

Are there any other symptoms of pregnancy? Yes; the 
presence of kiesteine in the urine is looked upon as affording 
a symptom of value, not always to be depended upon how- 
ever, as it rnav exist in certain diseases; but taken in con- 

22 



250 



OBSTETRICS, 



ne.'tioii with other symptoms it may bo valuable in coming 
to a conclusion. 

Of the Action of the Uterus 

What are the actions of the uterus'? It has two. The 
first tends to reduce it to its original size after having been 
distended; this is called its tonic action, It is accomplish- 
ed by all the fibres gathering themselves to a common cen- 
tre, but particularly by the circular fibres. 

The second acts only when attempting to expel some- 
thing, and is alternate in its action; it lias been termed 
the spasmodic or painful contraction of the uterus; and never 
t akes place unless the tonic action is perfect or nearly so. 

Retroversion of the Uterus. 

What is meant by retroversion of the uterus? It is where 
the fundus is precipitated bask wards, and places itself be- 
tween the rectum and bladder; while the neck is mounted 
up behind the symphysis pubis. 

At what time may this displacement take place? Either 
in the unimpregnated or the impregnated state;, but usually 
in the latter. It occurs mostly between the second and 
fourth months of pregnancy. 

What are the causes? Whatever tends to depress the 
fundus; such as blows, pressure, sudden exertion, violent 
efforts to -#omit r coughing, an over distended bladder, and 
an accumulation of faeces in the rectum. 

What are the symptoms? When suddenly produced the 
symptoms may be severe; an immediate interruption to the 
flow of urine, or to the passage of the faeees, alternate 
pains, bearing down, disposition to faint, &c. When slowly 
induced the symptoms are the same only less urgent and 
severe, but increase in intensity as the uterus is developed, 
until relieved. The diagnosis should be verified by the 
touch; and the disease may easily be distinguished by the 
vagina interposing between the finger and the tumour, the 
neck being mounted up behind the symphysis, and by its 
being obstinately fixed in its position. 

What is the treatment? The catheter should be used, 
and the bowels emptied daily; if this plan does not succeed 
it should be replaced by mechanical means. The plan then 
^o be pursued is to empty the bowels, either by injections or 



OBSTETRICS. 



551 



a cathartic; draw off the urine with an elastic catheter; and 
bleed to fainting or nearly so. The bed should be prepared 
in such a manner that the patient may lay upon her back, 
with the perineum free from the edge of the bed, and the 
parts should be well lubricated with oil or lard. When 
faintness is induced by bleeding the woman should be placed 
in the above position; the fingers should be placed so as to 
form a straight line at their extremities; they must then be 
gently pressed against the base of the tumour in the vagina 
so as to move it backwards and upwards, along the hollow 
of the sacrum, until it is placed above the projection of this 
bone; the hand should be withdrawn, a pessary introduced, 
and the woman kept quiet in bed for some days. 

Anteversion of the Uterus. 

What is anteversion of the uterus? It is where the fun- 
dus is thrown forward and downward, so as to prem against 
the posterior and inferior portion of the bladder, while the 
neck is carried forwards towards the projection of the sa- 
crum. The symptoms are not as severe as in retroversion. It 
may generally be relieved by opening the bowels and draw- 
ing olf the urine. 

Of the Obliquities of the Uterus. 

How are they divided? Into right and left lateral, and the 
anterior. 

What is the treatment for these displacements of the 
uterus? Before labor the woman should wear a bandage 
or supporter. 

During labor the axes of the uterus and pelvis should be 
made to correspond, by placing the patient on the side oppo- 
site to the obliquity, and bringing the fundus into its proper 
place. If this does not accomplish the object the os uteri 
should be hooked down by the finger, and brought to cor, 
respond with the axis of the pelvis? 

Of the Term of Utero -gestation. 

What is the average term of utero-gestation ? About nine 
calender months or forty weeks. 

What is the most favorable period for conception ? Im« 
mediately after the menstrual evacuation,, 



OBSTETRICS, 



Of Labouk. 

What is understood by the term labour? It is the expul- 
sive efforts of the uterus and mother in evacuating the con- 
tents of the uterus. 

Is its cause well understood ] It cannot be explained in 
the present state ot our knowledge. 

Has the mind any influence on labour? Mental impres- 
sions may excite labour in some cases, and in others sus- 
pend, or prevent it. 

Is the foetus active, or passive daring labour? It is en- 
tirely passive; being acted upon by the uterus mainly, as- 
sisted by the voluntary powers of the mother. 

What are the symptoms of labour? They are rigors^ and 
nervous symptoms, frequent inclination to make water, or a 
suppression of it, tenesmus, the subsidence of the abdomi- 
nal tumour, secretion of mucus, dilatation of the mouth of 
the uterus, and its alternate contractions. 

By what sot of fibres is the os uteri opened ? By the lon- 
gitudinal, which are opposed by the circular. 

Into how many stages is labour divided? Three. The 
first is the period of dilatation of the os uteri sufficient to 
permit the child to pass, and occupies about ten twelfths of 
the whole duration of labor. 

The second is the period of expulsion of the child from 
the uterus, and occupies about one ninth. 

The third stage includes the complete expulsion of the 
membranes and placenta, and occupies about one twenty- 
fourth of the whole duration of labor. 

Are the active duties of the accoucheur numerous in a 
natural labour? No; he should watch with care its pro- 
gress and attending symptoms, so as to be able to render as- 
sistance promptly in case of difficulty; but should not inter- 
fere when the case is a natural one. To bo able to discrimi- 
nate where interference is necessary requires an accurate 
knowledge of a healthy labor, and the deviations to which 
it may be liable. 

W 7 hat should bo the position of the woman during labour? 
She should be placed on her left side at the foot of the bed 
in such a manner that she may fix her feet firmly against 
the bed posts; her hips within ten or twelve inches of the 
edge of the bed, with the lower extremities flexed, and the 
bead supported by pillows. 



OBSTETRICS. 



253 



The bed should be properly protected by folded blankets 
from tho discharge. 

What time would you choose for making an examination 
of the progress of labour? The finger should be introduced 
into the vagina during a pain ; the examination of the pre- 
senting part and of the condition of the os uteri should be 
made both during pain, aDd in its absence. 

Should the membranes be ruptured during labour ! 
When the membranes remain entire, and the pains are effi- 
cient, with the os uteri dilated or dilatable, they should be 
ruptured by pressing the fingor against them, or by cutting 
them with the nail. 

When the head is emerging under the arch of the pubes 
what are the duties of the accoucheur '? He should support 
the perineal tumour with the palm of the left hand, and re- 
tain it there until the head is freed from the vulva. 

When the head is in this position is it proper to act upon 
it, and extract the foetus? Xo; the delivery should be trust- 
ed to the action of the uterus, unless it should become sus- 
pended, and there is danger of the life of the child. By a too 
sudden delivery alarming hemorrhage may result. 

What is the first great object as regards the child after 
delivery? To establish respiration, which generally takes 
place spontaneously; if it does not, measures should be ta- 
ken to produce artificial respiration; and heated cloths 
should bo applied to the child rather than -the warm bath. 

What are the means employed in producing artificial res- 
piration? The nostrils should be closed, aad air forced into 
the mouth either by the bellows, or from the mouth of the 
accoucheur; and again expelled by gently pressing upon tho 
thorax. 

To what period after birth may respiration be suspended 
and yet the child live? For thirty, or even forty minutes in 
some instances; so that our efforts should be continued so 
long as there is any chance of Life.. 

At what time is it proper to put a ligatuie on the cord, 
and cut it? ^ When the child cries, or respires freely; and 
there is evidence of a proper supply of arterial blood/ 

How many ligatures are necessary ? One; except there 
be twins, in which case two are necessarv. 

After the child is separated from the mother and given to 
the nurse what should then be attended to ? Tho condition 
of the uterus should be ascertained bv examining it throuo-h 



254 



OBSTETRICS. 



the parieties of the abdomen; when it will either be found 
contracted or relaxed. 

If contracted the placenta may be in the vagina, and easi- 
ly hooked down with the fingers and drawn by the cord; 
when it has passed the os externum it should be grasped 
and twisted several times round, so that the membranes 
may be entirely withdrawn. 

If the uterus is relaxed frictions should be made over the 
abdomen so as to produce contraction. 

The condition of the uterus should be watched until its 
permanent tonic contraction is well established. 

What is understood by putting the patient to bed? It con- 
sists in the removal of wet things and substituting dry ones ; 
in being lifted where she is permanently to lie; and in the 
application of a bandage over the abdomen. 

At what time should it be done) If she is not in a pro- 
fuse perspiration, is not liable to, or has no hemorrhage, or 
not much exhausted, it should be done immediately. 

Upon what does after pains depend and what is the rem- 
edy? After pains are produced by coaguia in the uterus, 
which are caused by a deficiency of its tonic contraction. — 
The proper remedies are camphor, opium and its prepara- 
tions, and the extract of hyosciamus. 

What should be the diet of a woman after delivery? 
Gruel of oatmeal, tapioca, sago, mush and milk, rice, weak 
tea, coffee, and chocolate. Animal food, spirits, wine, cor- 
dials, and all stimulating articles should be strictly avoided. 
Aftei the first week she maybe allowed some oysters, eggs, 
beef tea, &c. 

When should the child be put to the breast? If there is 
danger from hemorrhage it should be applied as soon as pos- 
sible; and at any rate as soon as it can be done convenient- 
ly without too much annoyance to the woman. 

If the bowels should be confined, at what time would it 
be proper to give a cathartic? On the third day; previous 
to this, unless there is some particular indication to fulfil 
the bowels should not be disturbed. 

The state of the bladder should also always be attended 
to. 

What is meant by the lochia? The discharges which 
take place from the uterus after delivery. 

Is it necessary to administer purgatives to young chil- 
dren? It ia necessary that the bowels should be thorough- 



OBSTETRICS. 255 

ly cleansed of the meconium, either by their natural action, 
or by some laxative as molasses or castor oil ; but so soon as 
there is a change of color produced in the evacuations they 
should be discontinued. 

The condition of the bladder of the child should also be 
attended to, and relieved if urine should accumulate in it. 

Is it proper to feed very young children? Provided tho 
m other does not furnish a supply of milk sufficient, but not 
otherwise; the child may have a little fresh cows milk dilu- 
ted with one third water, and sweetened with loaf sugar. 

Of Natural or Unassisted Labour. 

What is meant by a natural labour? Every labour may 
be considered natural, in which the woman might be de- 
livered without help. 

What conditions should exht that natural labour may 
take place? There should be regular contractions of the 
uterus, a favorable presentation, the pelvis of a proper size, 
a proportionate head, and the soft parts relaxed. 

What are considered to be the natural presentations? 
There are four; 1st. of the head — 2d. of the feet— 3d. of the 
knees — and 4th. of the breech. 

Of these which is tho most frequent, and the most favora- 
ble? Tho presentations of the head. 

How are presentations of the head divided? There are 
six. 

What are their positions, and how are they distinguish- 
ed? The first, which is known by the posterior fontanelle 
being behind tho left acetabulum, and the anterior before 
the right sacro-iliac symphysis. 

The second, distinguished by the posterior fontanelle be- 
ing behind the right acetabulum, and the anterior before the 
left sacro-iliac symphysis. 

The third, distinguished by the posterior fontanelle being 
behind tho symphysis pubis, and the anterior before the 
projection of the sacrum. 

The fourth, distinguished by the anterior fontanelle being 
behind the left acetabulum, and the posterior before the 
right sacro-iliac symphysis. 

The fifth, distinguished by the anterior fontanelle being 
behind the right acetabulum, and the posterior before the 
right sacro-iliac symphysis. 

And the sixth is the reverse of the third. 



OBSTETRICS. 



To remember these presentations easily, notico that the 
1st. 2d. and 3d. presentations are represented by the posterior 
fontanelle; and the 4th. 5th. and 6th. by the anterior fonta- 
nelle; and that we constantly follow their numerical order, 
commencing with the left acetabulum, then with the right, 
and go to the symphysis pubis; each fontanelle following 1 
the same rout and order. 

What are the distinguishing marks of the presentation of 
the head! Its roundness, firmness, sutures, and fontanelles. 

The particular position of the head relatively to the pel- 
vis is determined by the situation of the sutures, and fonta- 
nelles. 

Mechanism of Labour. 

What is the mechanism of the first presentation? The 
head enters the superior strait obliquely in the position de- 
scribed in the first presentation. 

The head is flexed with the chin on the breast, and de- 
scends in this position in the axis of the superior strait. — ■ 
When it arrives at the sacro-sciatic ligaments rotation is 
performed by the head of 1-6 of a circle, while the body re- 
mains in the same position; the centre of the occipital bonci 
will then be found to correspond w T ith the symphysis pubis, 
and the sagittal suture with the antero-posterior diameter of 
the pelvis. As the head advances the chin departs from th ? 
breast, the vertex advances, separates the external parts, 
rises up towards the mons veneris, and describes about a 
quarter of a circle backwards; this motion is called exten- 
sion, and may be considered perfect just as the face is clear- 
ing the perineum. As soon as the head has escaped exter- 
nally it takes a position at right angles with the shoulders, 
or its natural position in relation to them; this is called res- 
titution. In these motions it will be seen that the small di- 
ameters of the head correspond with the small diameters of 
the pelvis; and that it executes four motions, that of flexion, 
rotation, extension, and restitution. 

Which shoulder presents at the symphysis pubis in this 
presentation? The right shoulder. 

WTiat is the mechanism of the second presentation? It 
is the same as the first, if we place the head in the position 
of the second presentation at the superior strait; and the left 
shoulder passes out under the arch of the pubes. 

What is the mechanism of the third presentation? In the 



OBSTETRICS. £57 

third position the head is presented at the superior strait 
with its longitudinal diameter corresponding with the ante- 
roposterior diameter of the pelvis; it descends in this man- 
ner and performs the motions of flexion, and extension, but 
not those of rotation, and restitution. 

Which shoulder presents to the symphysis in this presen- 
tation? There is no certainty whether it will be the right 
or left. 

What is the mechanism of the fourth position? The head 
presenting with the anterior fontanelle at the left acetabu- 
lum descends until a portion of the right parietal bone rests 
upon tho inferior part of the sacrum when rotation takes 
place, and the forehead is placed under the arch of the pu- 
bes; the anterior fontanelle will be found in the middle of 
the arch; the posterior above the point of the sacrum; the 
occiput continues to advance over the coccyx and perineum 
until it is cleared from it; the occiput then turns backwards 
towards the anus of the mother, and the face disengages 
itself from under the pubes. 

Which shoulder presents to the arch of the pubes?- The 
left. 

To what position may this be changed with advantage? 
To the second; and the fifth may be reduced to the first. 

How is this accomplished? The uterus must be well di- 
lated, the membranes ruptured, the head occupying the low- 
er strait, and the labor active. The point of the fore-finger 
must be placed against the edge of the sagittal suture, be- 
fore or behind the anterior fontanelle; in the absence of 
pain press the part towards the left sacro-iliae symphysis, 
maintain it there during the next pain, and this must be re? 
peated again and again until we succeed. 

What is the mechanism of the fifth presentation? Tho 
relations of the childs head to tho pelvis are the same as in 
the fourth, only the anterior fontanelle at the superior strait 
is placed at the right acetabulum ; and the right shoulder 
presents at the arch of the pubes. 

What is the mechanism of the sixth presentation? This 
presentation is the reverse of the third; and in addition to 
the great diameter of the head being parallel with the small 
diameter of the upper strait, the forehead has to come under 
the arch of the pubes so that tho first part of the labour re- 
sembles cases of the third presentation ; and the latter part 
eases of the fourth, or fifth. 



258 



OBSTETRICS. 



Presentation of the Breech. 

What is the order of frequency of the natural presenta- 
tions ? The breech is next in frequency to the head; then 
the feet and knees. 

What is the principal danger in these cases where the 
body of the child is first delivered? It arises from delay in 
delivery of the head, and compression of the umbilical cord; 
consequently l breech presentations from the perfect manner 
which the external parts are dilated, preparatory to the pas- 
sage of the head, are less dangerous than the feet and 
knee presentations, although it may be a little more tedious 
to the mother. 

What are the symptoms of a breech presentation? It 
may bo known byjthe soft tumour wanting the characteristics 
of the head; having neither its sutures, hardness, or rough- 
ness. A deep grove is observed leading to the anus and 
parts of generation, and after the rupture of the membranes 
a discharge of meconium will corroborate, but not positively 
confirm the diagnosis. 

What are th.3 varieties of breech presentations? There 
aro four. In the first the lower part of the spine and sacrum 
offer to the left acetabulum, and the abdomen looks towards 
the right sacro-iliac symphysis. 

In the second the back of the child answers to the right 
acetabulum, and the belly to the left sacro-iliac junction. 

In the third the spine is behind the symphysis pubis, and 
the belly towards the projection of the sacrum. 

The fourth is the reverse of this last. 

What is the proper management of eases ef breech pre- 
sentation? It is not to interfere unless complicated with 
some circumstances which may render it necessary. 

Presentation of the Feet, 

What are the characteristics of feet presentations? They . 
are easily told by the projecting heels; the short toes, and 
Irom the hands to which alone they bear any analogy by 
the absence of the thumb? 

What are the presentations of the feet? There are four. 
In the first the heels are anterior to the left acetabulum, ancj 
the toes are directed towards the right sacro-iliac symphy s 
sis. In all these cases the legs are flexed upon the thighs, 
and the thighs on the pelvis. 



OBSTETRICS. 



259 



In the second the heels are behind the right acetabulum, 
irnu the toes look toward the left sacroiliac symphysis; in 
all these cases the other parts of the body correspond to the 
position of the feet. 

In the third the heels are at the symphysis pubis, and the 
toes to the sacrum. 

In the fourth the position is reversed, the heels are to the 
sacrum, and the toes to the pubes. 

Presentation of the Knee?. 

What are the presentations of the knees? There are 
four. Im the first the legs are to the left side of the mother 
and the thighs to ttae right. 

In the second the legs are to the right, and the thighs to 
the left. 

In the third the legs are under the arch of the pubes, and 
the thighs towards the sacrum. 

The fourth is the reverse of the third,- 

Of Labors in which the presentation is natural, but rendered 
difficult or preternatural. 

What are the causes which may render a natural labor 
preternatural? They are 1st. flooding: 2d. convulsions: 
3d. syncope: 4th. hernia: 5 th. obliquity of the uterus: 6th. 
partial contractions of the uterus: 7th. compound preg- 
nancy: 8th. descent of the cord: 9th. too short a cord: 
Itfth. bad position of the head: 11th* exhaustion: 12th. 
hemorrhages from the lungs, or other organs. 

Flooding as a complication of Natural Labor. 

Under what conditions of the os uteri may hemorrhage 
take place during labor? It may be either partially dilated 
and rigid; or it may be dilated, or easily dilatable. 

What should be the treatment when the os-uteri is rigid? 
There should be no hasty or rash interference, and it would 
be the height of imprudence to enter the uterus and attempt 
turning. The discharge should be controlled by rest, a hor- 
izontal posture, by blood-letting if indicated, large doses of 
acetate of lead, cold applications, and the tampon. In some 
cases when the above means fail, benefit may be derived 
from promoting the contractions of the uterus by rupturing 
the membranes. 



269 



OBSTETRICS. 



What should bo the treatment when the os-uteri is dilated 
or dilatable? We should at once proceed to turning, unless 
rupturing the membranes should abate the discharge, or the 
activity of labor promise a speedy delivery. If the labor is 
far advanced the forceps may be necessaiy. 

Convulsion?. 

What course should be pursued in convulsions as regards 
delivery? If the os-uteri is rigid deliveiy should not be at- 
tempted, blood-letting, cathartics, and such other means na 
may bo called for should be resorted to, until the uterus be- 
comes relaxed; when we may proceed to turn, unless the 
natural powers of the uterus are sufficient to accomplish a 
delivery. 

When the uterus is dilated or easily dilatable we should 
at once proceed to turning, after a copious blood-letting. — 
In cases where the waters have been long drained off, and 
the head low m the pelvis, we should use the forceps. 

Syncope 

What course should be pursued in cases complicated with 
syncope ? The cause should at once be sought out, and if 
it depends upon a peculiarity of the nervous system little 
need be done. But if it proceed from internal or concealed 
hemorrhage we should deliver immediately, unless the 
state of the os uteri prevent. 

Hernia. 

When a hernia is in danger of becoming strangulated 
what course should be adopted ) Turning, if the os uteri is 
in a proper condition. 

Bud Position of the Head. 

What may be considered bad positions of the head, par- 
ticularly when the head is relatively large, or the pelvis rel- 
atively small? When the head presents at the superior 
strait as in the third and sixth presentations. 

When the chin departs from the breast too early. 

When the face presents from excessive departure of the 
chin from the breast. 

And when some part as the hand or arm accompanies 
the head. 

What is the remedy for the first of tb can difficulties? 



OBTSETRICS. 261 

The head shall be grasped so that the thumb may lay on 
one side, and the fingers on the other; it shall then be 
raised, ami in the third presentation the vertex shall be 
turned towards one of the acetabula; if the right hand be 
used turn it towards the right acetabulum, and if the left 
towards the left acetabulum; then trust to nature. The 
sixth presentation should be changed either to the fourth or 
the fifth, which will bo as much rotation as the neck will 
bear. 

What is the remedy for too early departure of the chin 
from the breast ] It is to restore it by pushing up the fore- 
head in the absence of pain, and retain it there with the 
points of two or three fingers until a pain comes on, and the 
vertex is found to descend; it may then be trusted to nature. 

What are the varieties of face presentations? There are 
four; in the 1st the forehead offers to the left, and the chin 
to the right side of the pelvis; the 2d. is the reverse of 
this; in the 3d. the forehead answers to the symphysis of 
the pubes, and the chin to the sacrum ; the 4th, is the reverse 
of this. 

How may face presentations be distinguished ? By the 
presence of the eyes, nose, mouth and chin. 

At what period, and how may they be remedied? When 
the uterus is dilated or dilatable, and the head has not pass- 
ed the superior strait; with the waters recently expended. 
Pass the hand which is on the side on which the vertex and 
forehead are placed; in the first and second presenta- 
tions, put the the back of the fingers to the posterior 
part of the pelvis, and place them on the side of the head, 
while the thumb is placed against the opposite side; the 
head is then to be raised, the fingers carried over the ver- 
tex, and the thumb to the forehead; while the fingers are 
made to draw the vertex downwards the thumb is to press 
the forehead upwards. This is to be done in the absence 
of pain, and retained until a pain comes on, and the head 
takes the proper direction. 

In the third and fourth presentations turning is the proper 
remedy when the condition of the uterus will admit it. 

What is the proper remedy when the hand presents with 
the head? It should be prevented from descending by pla 
cing the point of the fore finger between the fingers of the 
child, and supporting it during a pain, at the same time di- 
recting it towards the face; as the head descends the hand 

23 



262 



OBSTETRICS. 



may in this way be made to retire within the cavity of the 
uterus. 

What is the remedy in the other cases of complication of 
a natural labor requiring interference? Turning 1 , when the 
condition of the os uteri will admit of it; but in no case is 
the uterus to be entered unless the os uteri is either dilated 
or easily dilatable. The forceps should be used when 
the head is low in the pelvis. 

What is the proper position of a woman for turning? The 
back is the best; with the lower extremities over the edge 
of the bed, and the feet resting on chairs, so as to leave the 
perineum and coccyx free. 

What time should be chosen for the introduction of the 
hand, and how should it be done? It should be formed into 
a cone, with the thumb looking towards the symphysis 
pubis, and introduced into the vagina during a pain, and 
into the uterus during its absence. 

Is it proper to turn a child after it has passed the os uteri? 
No; it should be done as soon as possible after the first stage 
of labor is completed. 

When the hand is in the uterus to what part should it bo 
passed? The hand should grasp the head with the fingers 
on one side and the thumb on the other, raise it in the axis 
of the superior strait, and place it in tho iliac fossa towards 
which the palm of the hand looks; where it must be re- 
tained by the wrist and forearm, whilo the fingers trace the 
side of the child to the feet, which should be grasped firmly 
and both acted upon at the same time when practicable. 

In what direction should the feet be conducted when 
bringing them down? So that the toes should always look 
towards the abdomen of the child. 

Is it proper to attempt to turn a child during a pain? No; 
the uterus might be lacerated. 

Is it proper to complete the delivery in cases of turning, 
or bring down the foet and permit the natural powers to 
finish? When commenced_it should bo completed slowly 
and steadily. 

W 7 hen the feet are brought through the oxternal parts 
what should be their position? The toes should look to- 
wards the anus of the mother; and when it is delivered be- 
yond the umbilicus it should be made to pass through the 
arch of the pubes with its spine looking towards, or pressing 
against either the right or loft leg of the pubes, that the 
head may enter the superior strait obliquely. 



OBSTETRICS. 



263 



When the axillae appear at the os externum what should 
be done? The one next the sacrum should be first deliver- 
ed, by passing a finger or two upon the point of the shoulder 
and pressing it downwards, tracing the arm to the elbow 
which may be pressed upon downwards and forwards to- 
wards the face of the child, where it will almost always bo 
disengaged. To deliver the second arm, turn the shoulder 
of that arm to that side of the pelvis to which the face of 
the child looks; and it will instantly become disengaged 
from the head at the small diameter of the superior strait, 
and may be brought down in the same manner as the first. 

When the child is all delivered except the head what 
should then be attended to'? The position should first bo 
ascertained; and if it does not already exist, a proper rela- 
tion should bo established between the diameters of the 
pelvis and the head of the child; a little force should now 
be applied in the direction of the axis of the superior strait, 
When in the inferior strait the proper relations should again 
be established between the diameters of the head and this 
part of the pelvis. 

The mother should now be directed ta assist by her vol- 
untary powers, and the child may be acted upon in the di- 
rection of the axis of the inferior strait, while we press 
against the occiput in such manner as will tend to disengage 
it from behind the pubes. 

What are the dangers arising from deliveries of this 
kind] Compression of the cord, compression of the head 
and chest, and extension of the neck. To obviate the last 
difficulty we should co-operate with the pains of the mother 
w^hen they exist, and the whole should bo conducted coolly 
and deliberately, 

Which hand should bo employed in cases of turning? 
Always use that hand which will look towards the face of 
the child. In the first presentation it will be the left hand; 
in the second the right; and for the third and sixth either 
hand will be proper, or the one of which we have the 
greatest command. 

Of the Forceps. 

What kind of forceps are geneially used? There are two; 
the shoit, and the long. 

The short are preferred when the head is very low in the 
pelvis, and the long when high up. The long forceps are 



264 



OBSTETRICS, 



however better adapted to both conditions, and should on 
the whole be preferred. 

What do the forceps resemble, and when are they indica- 
ted 1 They may be compared to a pair of artificial hands; 
and are indicated when the powers of the uterus cannot ac- 
complish delivery, when the case is complicated requiring 
immediate delivery, and the head passed the os uteri. They 
are, however, sometimes applied at the commencement of 
the second stage of labour, but it should only be attempted 
when turning is practicable, by a person well skilled in their 
use. 

What is the best position of the woman for the applica- 
tion of the forceps? The one recommended for turning. 

Should the condition of the bladder and rectum be atten- 
ded to? They should both be emptied before the forceps 
are used ; the external parts, and the instrumets should also 
be coated with hogs lard. 

What should be the condition of the os uteri, and mem- 
branes? The os uteri and external parts should bo relax- 
ed, and the membranes ruptured. 

To what parts of the head should the blades of the for- 
ceps be applied ? To the 3ides of the head over the ears of 
the child in the direction of its oblique diameter; and so 
that their concave edges will come under the arch of the 
pubes at the last period of labour. 

In cases of difficulty in causing the handles of the instru- 
ment to join should they be brought together by force } 
No; the cause of their not locking must be ascertained, and 
remedied; force should never be used. 

What are the mi des of action of the forceps? They have 
two modes of action; that of compression, and that of trac- 
tion and compression. 

May the life of the child be destroyed by compression 
from the use of the forceps? It may; care should be taken 
in this respect, and after each tractive effort the forceps 
should be permitted to expand themselves. 

In what manner should traction be made? It should be 
made from blade to blade, so that each may act as a lever 
upon the head. 

The extent of this motion of the handles must be govern- 
ed by the distance of the head from the external parts; tho 
less the head is advanced the more circumscribed should be 
the motion, and tho reverse. The general direction of this 



OBSTETRICS, 



traction should correspond with the axis of that part of the 
pelvis through which the child is passing. 

Should a labor be completed by the forceps in all cases 
where their application is necessary } They may be remov- 
ed when the head has nearly passed through the external 
parts, provided the pains continue, but not otherwise, 

Of Locked or Impacted Head, 

What are the varieties of locked head? There are two : 

1st. Where the head is jammed with its greatest length 
between the pubes and sacrum. 

2d. Where its thickness cannot pass owing to the narrow- 
ness of the pelvis. 

m the first place the points of pressure are the forehead 
and occiput, and in the second it is the parietal protuber- 
ances. 

What are the causes? Long continued and vehement ac- 
tion of the uterus, and a disproportion between the diame- 
ters of the pelvis and head; either from malposition of the 
head, its size and solidity, or from deformity of the pelvis. 

What are the attending symptoms of a locked head? Im- 
mobility, accompanied by swelling of the!hairy scalp of the 
child, thickening of the os uteri, a swelling of the vagina 
and external parts. 

What are the dangers'? The mother is exposed to inflam- 
mation, sloughing, and gangrene, and the child to almost 
certain death. 

What are the indications? The delivery of the child; 
which should be effected by the forceps if 'the child is liv* 
ing, and if dead the crotchet may be employed. 

Uterine Hemorrhage, 

How is uterine hemorrhage divided ? Into ihe acciden- 
tal, and the unavoidable. 

What is meant by accidental hemorrhage? It is that 
which occurs at any period of pregnancy from a detachment 
of the placenta, when situated at the body, or fundus of the 
uterus. 

What is meant by unavoidable hemorrhage ? It is that 
which occurs from the situation of the placenta over the 
mouth of the uterus, 

23* 



266 



OBSTETRICS. 



Accidental Hemorrhage. 

At what period of pregnancy may accidental hemorrhage 
take place ? At any time after the first month. 

What is the period of the greatest danger ? As a gener- 
al rule it is in proportion to the advancement of pregnancy. 

What is the division of accidental hemorrhage for prac- 
tical purposes? There are four divisions. 

1st. Hemorrhage which occurs at the peiiod when the 
ovum is entirely surrounded by the decidua, and decidua 
rellexa; comprehending the first four or four and a half 
months of pregnancy. 

2d. That which occurs during the remaining period of 
utero-gestation. 

3d. That" which occurs between the birth of the child, and 
the expulsion of the placenta. 

4th. Thai which occurs subsequent to the expulsion of 
tho placenta. 

What are the attachments of the ovum during the first 
period? It is attached to the parieties of the uterus at all 
points of its surface; and when separated entire resembles 
an ovular, spongy, fleshy mass. Hemorrhage muy occur 
therefore from its separation at any part. 

What is the condition of the neck of the uterus indicat- 
ing abortion? When it becomes distended so as to resem- 
ble in feel the extremity of an egg, abortion will take place 
most certainly, 

Tho cessation of morning sickness, a diminution of the 
abdominal tumour, tho painful distention of the mamma? 
with milk followed by flaccid breasts, also, almost certain- 
ly indicate that abortion will take place. Neither pain, or 
flooding are positive symptoms that abortion will follow. 

What are the indications in the treatment during this pe- 
riod? To arrest the bleeding, subdue pain if present, and 
prevent a recurrence of the hemorrhage. 

By what means may these be accomplished ? By perfect 
rest of body and mind ; the bed should be a mattrass, or 
sacking bottom. Feather beds should be avoided. The room 
should be ventilated, the patient thinly covered, the drinks 
cold, and every thing of a stimulating nature entirely pro- 
hibited, either for food or drink. 

Bloodletting may be used or not, according as it may or 
may not be indicated by the torce of the arterial system. 



OBSTETRICS, 



Acetate of lead should be given in doses of two or three 
grains guarded with opium every half hour, or twenty or 
thirty grains with a drachm of laudanum dissolved in a gill 
of water or starch may be used as an enema, and repeated 
if indicated. 

If pain exist opium should be given so as to create a de- 
cided impression upon the uterus, or else proves itself una- 
vailing. 

Ice water maybe applied to the pubes when the discharge 
is profuse, but our greatest reliance should be on the tam- 
pon; the best of which is a fine sponge of sufficient size to 
fill the vagina. 

In all cases where the hemorrhage is alarming whether 
there is a certainty that abortion will take place or not, we 
should use the proper means for arresting it, and the tam- 
pon will almost certainly do it. 

At what period may the ovum bo pierced for the purpose 
of arresting hemorrhage ? Never before the fifth month — 
and when it is ruptured before this period the treatment of 
the case is more tedious from the retention of the placenta. 

When the ovum or placenta is partially expelled, and he- 
morrhage is kept up by their presence what course should 
be adopted? It should be removed by the finger, Dewees' 
hook, or by forceps invented for this purpose. 

Sometimes ergot will act efficiently in removing them, 
and may be given when the hemorrhage is not violent. 

What are the indications in the treatment during the se- 
cond period ? They are the same as for the first. 

The same rules and treatment should be put in practice at 
once, and the tampon 'used early. 

Suppose these means fail what should be done ? We 
should rupture the membranes, and proceed to deliver if ne- 
cessary, provided the os uteri is in a proper condition; 
when it is not we should rely upon the tampon until it be- 
comes so. 

In what other condition would it be improper to effect 
delivery? When the woman is reduced to the last extrem- 
ity of weakness, and the discharge suspended; but if it con- 
tinue it is the only chance remaining. 

What are the limits of the beneficial application of cold? 
When it has controlled arterial action, and perhaps produc- 
ed some contractions of the uterus; these being accomplish- 
ed little benefit can be derived from its continuance. 



OBSTETRICS. 



What are the modes of delivery to be resorted to? Turn- 
ing, and the use of the forceps under the restrictions hereto- 
fore mentioned. 

Can hemorrhage take place after delivery without a se- 
paration of a part or the whole of the placenta? It cannot, 

What are the immediate causes of this kind of hemor= 
fhage? A separation of the placenta, and atony or imper- 
fect tonic contractions of the uterus. 

What are the varieties? It may be external, or internal 
and concealed, 

What are the symptoms of concealed hemorrhage? 

There is a flaccid condition of the uterus, except of the 
neck which is contracted ; it becomes enlarged, and may 
even equal the size which it had before labor; the effects of 
the loss of blood are also soon exhibited, unless the hemor- 
rhage is checked. 

What are the means used for hemorrhage after delivery? 
The contractions of the uterus should bo excited, and con- 
tinued. Friction with the tips of the fingers over the fundus 
will generally produce it, but if it swell we should grasp it 
with a sudden but moderate force. While these measures 
are pursuing a dose of er*_ot should be given, which will not 
only contribute to the expulsion of the placenta, but will 
also ensure its contractions afterwards. 

If the hemorrhage still continue profuse, and the placen- 
ta retained the hand should be introduced, and the placenta 
removed; the excitement of this process will have a tenden- 
cy to produce a permanent contraction. The sudden appli- 
cation of cold frequently repeated also has a beneficial ef- 
fect in this way, applied either by wet cloths, by a douche 
on the abdomen, or as an injection into the uterus. Firm, 
steady, pressure over the uterus, but above all the applica- 
tion of the child to the breast will almost always bring 
about permanent tonic contraction; upon which alone the 
safety of the woman depends. 

What means may be adopted before delivery to prevent 
hemorrhage in women subject to it. By evacuating the 
waters, and diminishing the force of the circulation by ma- 
king the woman preserve a horizontal position, and by the 
interdiction of stimuli of every kind. 

What are the symptoms of encysted placenta from hour- 
glass contraction? It may be known by the fundus of the 
uterus reaching higher than common, by being smaller in 



OBSTETRICS. 



its transverse diameter; by an elastic feel of the cord; by 
the absence of pain, by the placenta not being within reach 
of the finger; when the hand is introduced the cord is 
found to pass through a small aperture, and the 
felt lying within the cavity formed by this contraction. 

What is the treatment ? As soon as discovered the wo- 
man should bo placed in the position for turning, the hand 
introduced into the vagina, and then passed along the cord 
until an entrance is gradually effected through the stricture; 
tho mass should then be separated if adherent, and brought 
away by a gentle, cautious, motion of tho hand. 

Una c oidable He m orrh ag e . 

At what period of utero-gestation may unavoidable he- 
morrhage occur? It generally occurs first between the 
sixth and seventh month, and gives us the first knowledge 
of the situation of the placenta over the mouth of the 
uterus. 

Why does it not occur earlier? Because the neck of the 
uterus is not unfolded before this period; therefore the pla- 
centa is not disturbed, or separated. It does not necessarily 
follow at this time, or before labor commences, but the pa- 
tient is unavoidably liable from the mechanism of the ex- 
pansion of the neck of the uterus. 

What are the symptoms of unavoidable hemorrhage? 
When the full time arrives hemorrhage comes on suddenly, 
and often alarmingly without pain; or if attended with pain 
it is increased at every pain. This should lead us to suspect 
a placental presentation or placenta prcsvia. The hand should 
be passed into the vagina, and the finger into the os uteri, 
where the placenta may be distinguished by its firmness 
and fibrous structure from a coaguium; to which alone it 
boars any resemblance. 

What is the treatment? In slight cases at the early pe- 
riods ct pregnancy the ordinary treatment of hemorrhage 
niay be sufficient; but when profuse, and having ascertained 
it to be a placental presentation, the condition of the mouth 
of the uterus should be ascertained If it is rigid we should 
use those temporizing means adapted to the case, among 
which the tampon stands first; and if it is dilated or dilata- 
ble recourse should be had to turning, subject to the rules 
formerly mentioned. Tho membranes should be preserved 
entire; the hand should be insinuated between the os uteri 



270 



OBSTETRICS. 



and placenta, at the part where the separation has taken 
place; then passed up between the uterus and membranes 
belore rupturing them. They may then be ruptured, 
the feet seized, and the child delivered; this operation should 
however be performed with the greatest care. 

Of Puerperal Convulsions. 

At what period of utero-gestation may a woman be at- 
tacked with puerperal convulsions? At any period, but 
more particularly after the sixth month. 

How are puerperal convulsions divided? They are divi- 
ded into the epileptic, the apoplectic and the hysterical. 

Do convulsions take place suddenly or are they preceded 
by premonitory symptoms. They aro generally preceded 
by premonitory symptoms. 

What are the premonitory symptoms? In the epileptic 
and apoplectic species they are a strong determination of 
blood to the head, producing headache, ringing in the ears, 
temporary loss of reason, giddiness, &c. 

What is the proper treatment for this stage ? Blood-letting, 
brisk purging, and low diet; which will generally prevent 
an attack. The longer the premonitory symptoms exist the 
milder will be the attack; the cases which are attacked 
very suddenly are generally fatal. 

What are the symptoms of the epileptic variety? After 
a longer or shorter continuance of the premonitory symp- 
toms the woman may be seized with quickly repeated 
spasms, violent agitation of the face, eyes, and the whole 
body. The face becomes flashed, livid, black, and the 
tongue is thrust between the teeth. The respiration is dis- 
turbed or suspended, the carotids beat violently, and froth 
issues from the mouth. The pulse in the beginning is full, 
frequent, and tense, but becomes rapid, small, and imper- 
ceptible, a cold, clammy sweat appears, and. the fit begins 
to decline. When the spasm goes off the patient generally 
remains comatose and insensible, wi'h stertorous breathing. 

These paroxysms may follow each other in quick suc- 
cession. 

There is also a variety of epileptic convulsions which are 
called anaemic, proceeding from a very different condition 
of the system, and maybe distinguished from the above by 
the pale face, glazy eye, shrunken features, colorless lip, 
cold moist skin, and other symptoms indicating a collapsed 
condition of the system. 



OBSTETRICS. 



271 



The treatment in these cases should of course be of a 
directly different kind. 

What are the symptoms of the apoplectic variety? The 
premonitoiy symptoms are of shorter duration than the epi- 
leptic, and those following are more violent. It may be 
considered as an exalted degree of the epileptic. 

What are the symptoms of the hysterical variety? We 
have not the same premonitory symptoms as we have in the 
epileptic; but we may have ringing in the ears, palpitation 
of the heart, globus hystericus, &c. The convulsions are 
not so violent, the face is less flushed, and the muscles on 
the posterior part of the body are generally violently con- 
tracted. This last circumstance is considered by Dr. Dewees 
as strongly characteristic of this variety of convulsions. It 
also attacks women of delicate and nervous habits. 

What is the proper treatment in the epileptic and apoplec- 
tic varieties? Bleeding should at once be had recourse to 
from a large orifice, and repeated as circumstances may in- 
dicate. Cathartics and purgative enemata should be given, 
cold applied to the head, and blisters or sinapisms to the 
extremities. Whenever the cs uteri is in a proper condition 
we may finish the labor if it have commenced, by turning 
or the forceps; our choice depending upon the stage of la- 
bor, and the circumstances regulating the application of 
each. 

What is the treatment for the hysterical variety? A 
moderate bleeding in most instances, followed by tincture 
of assafcetida and laudanum, cold dash, &c. 

Of Inversion of the Uterus. 

What is meant by inversion of the uterus? It is where 
the fundu > is forced down into the cavity of the uterus, 
and through the os uteri into the vagina, or where the whole 
uterus is turned inside outwards, and the fundus appearing 
at the os externum. The former is termed partial and the 
latter complete inversion. 

Under what circumstances may inversion of the uterus 
take place? In certain cases of polypus and immediately 
after delivery. 

What are the causes? Any foice applied to the fundus 
whether by the cord or externally, immediately after having 
been emptied suddenly, violent straining, attempts at cough- 



OESTETRICk 



ing, sneezing, or by any sudden action of the abdominal 
muscles. 

How may an inversion be distinguished? In the partial 
it may be known by the absence of the hard spherical tu- 
mour of the fundus above the pubes, and by the presence of 
a globular fleshy body in the os uteri, which is sensible to 
the touch. 

The patient complains of a dragging sensation in the 
groins and lumbar region, compelling her to strain violently; 
there is hemorrhage, an oppressive sense of sinking, with 
nausea or vomiting, cold sweats, faintings, and oiten con- 
vulsions. 

In the complete the hemorrhage and violent pain are ab- 
sent; although death may suddenly follow from the shock 
received by the nervous system, or from fainting. 

What is the treatment ? It should be returned immedi- 
ately, and the difficulty of doing this will be in proportion 
to the time elapsed from the accident. When the placenta 
is adherent there is a difference of opinion whether we 
should remove it or return it with the uterus, and allow it 
to be thrown off afterwards by the contractions of this or- 
gan. In cases of complete inversion the better practice is 
to separate it, as there is comparatively little danger from 
hemorrhage. 

In the partial perhaps it would be better to attempt to re- 
place the uterus with the placenta, but if it offer much rc- 
sistence and delay to the reduction, it should be at once re- 
moved. 

What is the manner of reduction? The tumour should 
be firmly grasped and pushed up bodily in the direction of 
the axis of the os uteri; and we should endeavor first to 
return that portion of the uterus which was expelled last 
from the os uteri; when it has ascended so high that we 
are no longer able to grasp the tumour we should spread tho 
fingers at equal distances round it, and thus apply the pres- 
sure over a large space; the direction of this pi\ssuro will 
vary with the axis of the pelvis; when the fundus passes 
the os uteri it usually recedes suddenly. If we find the 
uterus contracted above the pubes, tho hand may be with- 
drawn; but if it is flaccid and soft the hand should be in- 
troduced into the uterus so as to excite active contractions, 
and prevent a return of the fundus. The patient should 
then be kept quiet, and not allowed to make any sudden 



OBSTETRICS. 



273 



exertion. When the uterus is partially inverted, and can- 
not be replaced, it is preferable t iat we should make the 
inversion complete, as recommended by Dr. Dowees. In 
some cases of these chronic inversions the uterus has been 
removed by ligature. 

Of Twins. 

What is the average proportion of twins in this country } 
About one in seventy-five. 

How are twins situated in regard to each other? They 
may be enclosed in one common covering of membranes 
and float in the same waters. In other instances they may 
each have a separate amnion, while the chorion may be 
common to both; or each may have its own membranes, 
waters, and placenta. — Dewees. 

How may a case of twins be known after the birth of the 
first child ? The abdominal tumour does not subside as it 
does in a case of a single child. The child may bo felt 
through the abdominal and uteri no parieties; the re is gen- 
erally a renewal of the pains, and the child can be felt per 
vagi nam. 

After the birth of the first child, and it is ascertained that 
there is a second, what is to be done? Pain will either 
come on and deliver the child, (in which case we should 
conduct the case as though it was an original labor,) or 
there will be a suspension of pain. 

How arc we to proceed when there is a suspension of 
pain? In this case the uterus will bo cither contracted or 
uncontracted. If in the first condition there may be he- 
morrhage; we should treat it as any other case of hemor- 
rhage, and deliver if necessary; or hemorrhage may be ab- 
sent, in which case friction should be made until it 
eontrac ts. 

If contracted, and pains do not pretty soon follow, say in 
half an hour, it w r ill be better to proceed to delivery; but 
in no case where hemorrhage is absent without this* tonic 
contraction being secured. 

Of the Presentation of the Ann and Shoulder. 

What are the presentations of the arm and shoulder ?- 
They may present in four different ways at the superior 
strait. 

The position of the shoulder will be difficult to d'stin- 

24 



OBSTETRICS. 



guish unless the arm is also down; in which case it will 
servo to indicate the position of the shoulder. 

In the first position the head and side of the neck of tho 
child is. to the leftside of the pelvis; and the right arm 
down, with the back of the hand anterior, and tho palm pos- 
terior. 

In the second the head and side of the neck will be to 
the left side of the pelvis, the palm of the hand will look 
outwards and the back to the posterior part of the pelvis. 

In the third the head and side of tho neck will be to the 
right side of the pelvis; the left arm down with its back 
looking outwards, arid, the palm inwards. 

In the fourth the right arm will be down, with the palm 
looking outwards, and the back inwards. 

When turning is resorted to which hand should be used 
in these presentations? In the first and fourth the right 
hand must be used, and in the second and third the left. 

What use should be made of the arm in shoulder presen- 
tations'? It offers no indications except that it points out 
the situation of the shoulder. There can be no manoeuvre 
nerformed upon it to advantage, so that traction, amputa- 
tion, &c, should be entirely avoided. 

What are the indications in these presentations? They 
are to bring down the feet, and deliver. 

T.*ere are however three modes pursued in these cases: 
One is to turn; the second Is to trust to the powers of nature 
to produce the "spontaneous evolution" of the child; and 
the other is to use cutting instruments to the child. 

The first should always be practiced when it is possible 
to do it, and the earlier (when the os uteri is in a condition 
to permit it), the better. 

When the waters have been long drained off and the 03 
uteri and other parts of the uterus are firmly contracted so 
as to oppose the introduction of the hand, and the parts are 
pushed down low in the pelvis, turning cannot be permitted. 

This condition should be counteracted by tho free use of 
the lancet and opium; as soon as relaxation is induced wo 
may turn, unless the shoulder is too firmly wedged to per- 
mit it to be raised. When the child is dead and in this con- 
dition we may deliver by tho use of instruments. 

Prolapsus of the Umbilical Cord. 

What danger is to bo apprehended from prolapsus of the 



OBSTETRICS. 



cord? It may be compressed, and the life of the child de- 
stroyed by the interruption to circulation. 

How may it be distinguished ? Before the rupture of the 
membranes we may possibly feel a pulsating, projecting 
mass like a finger; when the membranes are ruptured the 
cord comes down, and may form a large coil. 

What is the treatment? When left to itself the child is 
generally destroyed, unless there is a very quick labor. 

The remedies are generally turning, and delivery by the 
forceps. It is also advised to make attempts at replacement, 
but it does not always succeed. When the labor advances 
very rapidly sometimes the cord may be protected by plac- 
ing it in that relation to the head and pelvis where it will 
bo least pressed upon. 

Of Rupture of the Uterus. 

What are the causes of rupture of the uterus? Blows, 
violent pressure, ill conducted attempts to turn the child, 
mal-adroit use of instruments, the unequal surface of the 
child, a contracted pelvis, an unusual sharpness of the linea 
ilio-pectinea, exostoses, tumours, scirrhi, and ulcers. 

It what portion does it usually happen? It most common- 
ly happens at or near its junction with the vagina, but may 
occur at any part. It may be more or less extensive, and 
may be complete, or partial. In the first case the uterus and 
peritoneum are both ruptured; in the second the uterus 
alone is involved. 

What are the symptoms? There is sudden acute pain at 
the point of the rupture, a discharge of blood, a cessation of 
uterine contractions, great consternation, the presenting part 
recedes, the face becomes pale and cold, the respiration hur- 
ried, and vomiting takes place; loss of sight, faintness, con- 
vulsions, and death follow. 

What is the treatment? Delivery should be effected as 
speedily, and gently as possible. 

Gastrotomy may be performed when the whole child has 
passed into the cavity of the abdomen, and it is impossible 
to seize the feet. 

Of Deliveries Performed by Cutting- Instruments af* 
plied either to the Mother or- Child. 

What are the causes which may render one or the other 



27d 



OBSTETRICS, 



of these expedients necessary 1 ? Deformity of the pelvis, and 
deformity of the child. 

What may bo considered as the resources of our art in 
cases of deformity of the pelvis? Turning, forceps, cepha- 
lotomy, Caesarian operation, premature delivery, section of 
the pubes, and regimen during pregnancy. 

Under what circumstances may turning be Adopted? 
The rules already laid down should be attended to, and it 
.should not be resorted to when the antero-posterior diame- 
ter at the superior strait is less than 3£ inches; and then it 
may be considered as a remedy for the safety of the mother 
rather than the child. 

What is the smallest diameter of the pelvis at the superior 
strait in which the forceps may be safely used? Three 
inches; then the head of the child should be of moderate 
size, yielding, and the forceps skilfully used. They are pref- 
erable to turning in most cases of deformity. 

Under what circumstances may ccphalotomy be resorted 
to? We may resort to the perforator and crotchet in cases 
where the antero-posterior diameter is 2£ inches or more, 
and is so small that the head cannot be delivered by the for- 
ceps. 

If the child is living we should choose between this, and 
the Caesarian operation; the latter of which in many re- 
spects should be preferred. 

What are the smallest diameters admitting of delivery 
per vias naturalcs by the crotchet? Two inches in the an- 
tero-posterior, and three or three and a half in the trans- 
verse. 

What is understood by premature delivery? It consists 
in inducing* labor artificially at a period of pregnancy when 
the child is sufficiently developed to exist after birth, and 
yet so small, and the bones of the head so soft as to pass 
through the contracted pelvis of the mother. 

What is the proper period for its performance? The most 
eligible time is between the thirty fourth and thirty sixth 
week of utero-gestation ; or if the deformity be very consid- 
erable we may commence operations as early as the thirty 
second week. The operation should be delayed in all cases 
as long as it can be done safely, as by so doing the labor 
will more nearly resemble a natural one, and the chances 
of the child are increased. 

What is the mode by tvhieh it is accomplished? Aceor- 



OBSTETRICS. 



277 



ding to the directions of Dr. Rigby we should first give a 
full dose of calomel and celocynth, so as to effectually clear 
out the bowels; then a warm bath; ergot should then be ad- 
ministered in scruple doses of the powder, and repeated ev- 
ery half hour for five or 3ix times- These means will gen- 
erally bring on labor; if they fail a catheter should be pass- 
ed, and the membranes separated from the uterus for some 
distance; if this fail then the membranes should be ruptur- 
ed. Others advise the rupture of the membranes, or their 
separation from the uterus to precede all other means. 

What are the benefits likely to result from a section of the 
pubes] It is an operation that is now almost universally 
condemned, and therefore not practiced. 



24* 



. PART VI. 

THEORY AND PRACTICE OF MEDICINE, 



Of Disease. 

How may diseases be divided? Into organic and func- 
tional. 

What is the character of the first class? There is a change 
which is appreciable by our senses, in the structure of 
one or more organs. 

What is the character of the second class? The disor- 
dered function is not attended by any appreciable lesion. 

Each of them may again be divided into acute and chronic, 
and general and local affections, 

Which of the two classes are generally the most fatal? 
Organic diseases; but several of the functional are extreme- 
ly mortal, as tetanus and hydrophobia. 

What is meant by local organic diseases? Those in 
which the important symptoms are local, and are nearly in 
proportion to the anatomical lesions found after death, when 
it tal^es place. They may be acute or chronic. 

What are the general organic diseases'] They are often 
chronic, as the tuberculous and cancerous diseases. The 
acute are certain epidemic dysenteries, fevers, scurvy, and 
gangrene. Tubercles are, however, sometimes acute. 

Which are the most manageable, the general or the local 
diseases? The local. The general can be rarely cut short 
by remedies; the treatment for these is more useful in obvi- 
ating the secondary inflammations that so often accompany 
them and prove the immediate cause of death, than in abso- 



PRACTICE OF MEDICINE. 379 

lutely terminating the affection itself. Treatment is, how- 
ever, important as it enables us frequently to conduct disease 
to a favorable termination which might otherwise prove 
fatal. 

May functional diseases be either acute or chronic] Yes; 
and they constitute a large class of affections. Sometimes 
they are a symptom of an organic disease. 

Do acute functional disorders ever simulate inflamma- 
tions'? They do; and ii requires care and experience to 
discriminate them. 

What are instances where they may be confounded ? 
Pleurodynia with pleurisy; and local pains occurring in 
hysteria with the acute phlegmasia? of t£ie viscera. 

How aio they distinguished 7 Acute functional disorders 
commonly assume the form of neuralgia?, in which the 
character of the pain contrasted with the slight vascular 
disturbance is sufficient to point out its true origin. 

Are these acute affections always limited to pain? They 
are not; they assume at times every variety which the change 
in the function of an organ can produce, and are often diffi- 
cult of diagnosis and treatment. 

How is a diagnosis to bo made in these doubtful cases? 
By exclusion; and by this means we can frequently affirm 
that tho absence of unequivocal signs ol organic lesion, is 
conclusive proof that the disturbed function depends upon 
a cause which is connected with the nervous organization 
of a part, and not with a material change of the structure. 

Are the chronic functional disorders sometimes mere symp- 
toms of a distant local affection? They aro ; and at other 
times independent. 

What are some of the chronic functional disorders? Most 
cases of mania, hysterical affections, many cases of dys- 
pepsia, &c. 

Are the functional disorders numerous? They are as nu- 
merous as tho organic lesions, and much mere difficult to 
manage. 

Is classification arbitrary? It is; and the nomenclature 
also in many instances. 

What enhances this difficulty? The circumstance that 
many lesions which are separated as distinct diseases from 
others of a similar nature are in reality the effects, and not 
the cause of diseased action. Thus the term hydrothorax 
is now seldom used; the symptoms to which it was applied 



$m , PRACTICE OF MEDICINE, 

are still observed; but it is now known that they depend 
upon a disease of the heart, and the effusion of seram into 
the cavity of the chest is only a consequence. It is neces- 
sary however, for convenience, to name, classify, and ar- 
range the different forms of disease according to the facts 
we now possess. 

Semeiolog-y and Diagnosis. 

What is meant by semeiology ? The symptoms of dis- 
ease studied with reference to the internal changes with 
which they correspond. 

What is diagnosis'? It is the art of distinguishing one 
disease from all others, and is based upon the comparison of 
the symptoms we observe in a particular individual with 
those known to exist in other cases, in connection with the 
order of time which they appear. A more refined kind of 
diagnosis consists in determining the particular variety and 
stage of the disease, which includes prognosis or the art of 
determining the result. 

What are the signs of disease? They are the physical or 
those derived from a knowledge of the physical condition 
of the organs, obtained by physical examination; and the 
functional, to which the term symptom is usually confined. 

What class of diseases admit of both these means of di- 
agnosis? The organic; the functional can only be distin- 
guished by the latter. 

To what part are the physical signs particularly applica- 
ble? To diseases of the thoracic cavity, but they are by no 
means entirely confined to it. 

From what are the physical signs derived? From an in- 
spection of the exterior, from palpation or touch, and from 
auscultation and percussion. 

What does inspection of the exterior of the body indicate? 
Distention when a change of structure in the organs is suf- 
ficient to dilate the parieties. As in dropsy, tympanitis, ex- 
treme enlargements of the liver and other abdominal or- 
gans, emphysema, pericarditis and pleurisy with large effu- 
sion. Pleurisy after adhesion has occurred, and phthisis, 
cause contraction. 

What are the benefits of palpation? It assists ocular in- 
spection. We can bettor estimate slight elevations, and 
also the degree of sensibility of the surface and internal vis- 
cera. If the degree of sensibility of tho viscera is wished 



PRACTICE C>F MEDICINE, 



fot wo press gently and equally with the whole hand; if oi 
the surface wo pass the tips of the fingers lightly over the 
-kin? 

How is percussion performed ? By placing a pleximeter 
(and the forefinger of the left hand makes a very good one) 
on the surface, and tapping quickly but lightly upon it 
with the extremities and not with the pulps of one or more 
lingers of the right hand. 

What kind of knowledge is derived by percussion ? It 
enables us to distinguish the density of the part or organs 
beneath; as between a gat* which gives a clear resonant 
sound and a liquid or solid mass which yields a flat sound. 
We are therefore obliged to recollect what sound the part 
yields by percussion in a normal state, to determine the de- 
viations in disease. 

What is meant by auscultation? It is the art of distin- 
guishing by the ear sounds produced in the particular parts 
of the body in health and disease. 

How is it performed ? By applying the ear directly to the 
part, when it is immediate; or by using a tube called a ste- 
thoscope to collect and conduct the sound, when it is called 
mediate. 

This method of exploration is principally confined to dis- 
eases of the- thorax. 

What are the points to be observed in ausculting the 
chest ? The natural sound of respiration is heard principal- 
ly during the act of inspiration over the greater part of the 
chest, and is a soft regular murmur, with very little blow- 
ing sound. Between the scapulae, and at the summit of the 
right lung the inspiration is ol a moro blowing character, 
and the expiration is also heard at these points, from the 
nearness to the large bronchial tubes, and their preponder- 
ance over the vesicular structure. These blowing sounds 
are , however, slightly mingled with tho natural respiratory 
murmur. 

How are these blowing or bronchial sounds, and the ve- 
sicular murmur affected by disease? By enlargement of 
the tubes, cavities communicating with them, and harden- 
ing of the tissue of the lung. 

What names are given to the rude and blowing sounds of 
respiration which correspond to different states of the lung? 
Rude or rough respiration; bronchial respiration ; cavernous 
respiration; and the amphoric respiration. 



PRACTICE OF MEDICINE, 



What are the characteristics of the rude or rough respira- 
tion, and upon what condition of the lung does it depend? 
The vesicular murmur is usually more feeble than natural, 
but the blowing sound more distinct in both inspiration and 
expiration. Sometimes the vesicular murmur is exagerat- 
ed although the blowing sound is greatly increased. In the 
first kind there is equal hardening around the tubes; in the 
second the hardened masses are scattered through tho tissue 
of the lung which is permeable. 

What are tho conditions upon which the bronchial respi- 
ration depends, and what are the symptoms? It occurs when 
the tubes are dilated, and in complete hardening of the tis- 
sue around the larger bronchi. No murmur of vesicular ex- 
pansion is heard, the air sounds as if blown through a tube 
in inspiration, and seems to reverberate back again during 
expiration. When very strong it is called tubal respiration, 
which occurs in the second stages ot pneumonia, phthi- 
sis, &c. 

What are characteristics of the cavernous respiration, and 
upon what does it depend? It is similar to the bronchial, 
but more concentrated, and depends upon the existence of a 
defined cavity. It occurs in phthisis, and in gangrene of the 

lungs 

What are the characteristics of the amphoric respiration, 
and upon what does it depend? It is a modification of the 
cavernous, but more diffused and metalic in its character; 
it is caused by the hardened walls of a very large cavity, or 
from the pleura in pneumo-thorax. 

Are these modifications of respiration attended with cor- 
responding changes in the resonance of the voice? They 
are ; and it is heard more strongly in proportion as the res- 
piration becomes more decidedly bronchial, or cavernous. 

What is the corresponding modification of voice in the 
cavernous respiration? Pectriloquy. When bronchial, 
bronchophony. 

How is the state of the bronchial mucous membrane 
known? By the rhonchi; the sonorous and sibilant ronchi 
(giving rise respectively to a cooing and whistling sound), 
indicate thickening of the larger or smaller tubes, and are 
called the dry rhonchi. 

What are tho moist rhonchi ? The mucous, the sub-cre- 
pitating, and the crepitating. In the first the sound resem- 
bles that produced by irregular, but large bubbles of liquid; 



PRACTICE OF MEDICINE, 



283 



when intense it is called gurgling. The other moist rhon- 
chi are caused by smaller bubbles in the vesicles and finer 
tubes. 

In what diseases is the respiration feeble? Catarrh, em- 
pbysema, and the first stage of tubercular disease. 

What is the character of the sounds of the heart in a nat- 
ural state? Regular; the first sound is more dull and pro- 
longed, and occurs during the sj^stole ; the second is more 
sharp and short, and it is heard during the diastole. When 
the valves are diseased, or the blood is driven with ex- 
treme rapidity through the heart these sounds become 
rough. According to the degree of roughness they are 
then called bellows or rasping sounds. The thickness of 
the walls of the heart is estimated by the force of the im- 
pulsion against the thoracic parieties. 

What is meant by the functional signs of disease? They 
are partly those alterations in the functions that we observe 
ourselves; and partly the sensations experienced by the pa- 
tient, and by him communicated to the physician. By them 
we are assisted in determining the condition of the internal 
organs. 

In what order should these symptoms be examined? 
First, by observing the decubitus or position of the patient; 
and whether it be equally easy in all situations. The color 
and appearance of the skin and the expression of counte- 
nance often afford valuable evidence. The cerebral func- 
tions should be examined. The intelligence, memory, state 
of the senses, cutaneous sensibility, functions of motility, 
and the strength, furnish signs of disorder of this function, 
whether from functional or organic defect. 

The deglutition may furnish valuable signs. The various 
functional derangements of the thorax should be closely 
examined if they exist. 

The symptoms connected with the organs of digestion 
are very numerous, important and require an examination 
of the greater part of the alimentary tube. Under this head 
the state of the tongue and adjacent membranes should be 
examined. 

The secretions of the kidneys should be attended to, and 
chemical tests used if necessary. 

Chemical tests may also be used in examining other se= 
cretions. 



284 



PRACTICE OF MEDICINE- 



Fevek* 

What are considered to bo the essential symptoms of 
fever? A quick pulse, preternatural heat of the surface of 
the body, with a sense of chill ness at the commencement; 
are the most common symptoms of that condition we term 
fever. 

How is fever divided by pathologists] Into idiopathic 
and symptomatic; or primary and secondary. 

What is understood by idiopathic fever? It is where the 
fever does not depend upon a local fixed imflammation or 
irritation, but is produced and sustained by causes producing 
a general morbid state of the system. 

What is understood by symptomatic fever? It is where 
the fever is produced and kept up by a primary local inflam- 
mation or irritation. 

What are the causes of fevers? They are divided into 
the prodisposing, and exciting. 

The former are those external, and internal causes which 
tend to lessen the powers of the system to resist morbific 
agents, from tho existenc of some functional, or organic de- 
fect. 

The later are those which excite fever by deleterious im- 
pressions made on the system, and are checked perspira- 
tion, worms, atmospheric temperature, miasmata, noxious 
gases, heat, cold, electricity, humidity, mechanical injuries, 
and the various contagions. 

What is understood by miasmata) It is a morbific agent 
which acts through tho medium of the atmosphere, and 
eludes our most delicate chemical tests; but known from its 
effects on the human system. 

What are the conditions necessary lor its production ? 
The presence of vegetable, or animal matter in a partial 
state of decomposition; moisture and a certain degree of 
heat, say 80° or thereabouts. 

How is miasmata divided? Into koino- miasmata, and idio- 
miasmata. 

What is koino-miasmata? It is the product of the de- 
composition of marshes, and public filth of cities, called 
corn i only marsh-miasmata, or malaria. 

What is idio-miasmata? It is the product of the decom- 
position of the exhalations and secretions of the human 



PRACTICE OF MEDICINE. 



body [accumulated, and confined in ill-ventilated habita- 
tions. 

What is understood by contagion? It is a deleterious 
a^ent; the product of secretion of the animal body in a 
state of disease, which when applied to a healthy individu- 
al, either by direct contact, or through the medium of the 
atmosphere, produces a disease specifically similar to tHa 
one from which it derives its origin. 

What constitutes a course of fever? It is the series of 
phenomena which intervene between its commencement 
and termination in convalescence. 

How is the course of fever divided? Into intermitting, 
remitting, and continued; according as its phenomena in- 
teimit, remit, or are continuous. 

What are stages of a course of fever? They are the 
forming, cold, hot, critical, declining, and convalescing. 

What are the symptoms of the forming stage? Loss of 
appetite, disturbed sleep, yawning, stretching, wandering 
pans, an unpleasant sensation at the stomach, a general 
feeling of malaise, nausea, &c. 

What aie the symptoms of the cold stage? A sensation 
of chilliness, a pale contracted and dry state of the surface, 
the volume of the body is diminished, the respiration is 
confined, irregular, anxious, and oppressed, frequently with 
a short dry cough, dry tongue, thirst, pulse small, frequent 
and feeble, with nausea and vomiting. 

What are the symptoms of the hot stage? Augmented 
heat, fullness, and redish color of the surface, flushed coun- 
tenance, pulse full, quick, frequent and vigorous: or small, 
tense, quick, and frequent; throbbing in the head, eyes 
prominent, and sensible to the light; skin dry and hot; urine 
scanty high colored, &c. 

What is meant by crisis? It is that period at which the 
disease has arrived at the highest point, and either a favora- 
ble or fatal issue takes place; it is generally attended with 
some evacuation, as sweating, or increased flow of urine. 

What is meant by the revolution of a fever? It is the 
space of time occupied by one paroxysm of fever and its 
succeeding intermission; or the time which intervenes be- 
tween the regular periodical exacerbations of fevers not 
paroxysmal. 

What is the form which a fever assumes in respect to its 
revolution, called? Its tvpe. 

25 



PRACTICE OF MEDICINE. 



Intermittent Fevers, 

What are the types of intermittent fever? They are tho 
quotidian, when the period of revolution is 24 hours; ter- 
tian when it is 43 hours; quartan when it is 72 hours; and 
quintan when it is 98 hours. 

What are tho periods of a paroxysm of intermittent fe- 
ver) There are three; the cold, hot, and sweating-. 

What are tho varieties of intermittent fever ? They are 
the inflammatory, the congestive, tho gastric, and the ma- 
lignant. 

What time of year does the inflammatory variety occur? 
Mo&t frequently during the winter and spring. 

What is the most frequent type? The quotidian. 

What are the symptoms? In the hot stage the heat of 
surface- is intense, and the pulse is peculiarly strong, hard, 
and fall. Tho most characteristic mark of this variety is 
the want of a complete apyrexia between the paroxysms; 
the febrile symptoms continuing. 

In what class of persons do congestive Iiitermitterits oe- 
eur? In persons of exhausted or debilitated habits. 

What are the symptoms? The cold stage is protracted, 
there is deep seated pain in the head, vertigo, fainting, 
sense of weight or oppression in the breast, coma, a small 
weak nulse, hot stage comes on slowly and imperfectly, the 
breathing is confined and anxious, with an internal sensa- 
tion of heat. 

W T hat are the symptoms of gastric intermittonts? There 
are prominent symptoms of gastric and intestinal irritation, 
redundancy of biliary secretion, and other saburral matters 
lodged in the intestinal canal. They generally occur in 
autumn, and are attended with a foul and bitter tongue, 
much nausea, and bilious vomiting, an icteric hue of the 
skin, a sensation of weight in the right hypochondrium, and 
frequently with visceral disorders. 

What are the symptoms of malignant intermittents? A 
copious and foetid perspiration, colliquative hemorrhages, 
petechias, and othersympt orns of malignancy. 

What* is understood by masked agues? It is where other 
affections, such as neuralgia, sciatica, hemicrania, dysentery, j 
cholera, &c M occur in a strictly periodical manner; like in- i 
term'itteuts, 



PRACTICE OF MEDICINE. 



What is the most frequent cause of intermittent ?: Koiiio* 
miasmata. 

What is the treatment? It is divided into that proper 
during the paroxysm, and that which is to be employed 
during the intermission. Treatment is seldom necessary 
during the paroxysm in the intermittents of our climate. — 
If the cold stage is protracted, or there is much congestion, 
it may becomo necessary to administer stimulants, and ap- 
ply revulsives to the extremities. Bland warm drinks may 
also be given to allay thirst. During the hot stage it may 
be necessary to moderate excitement, and hasten the sweat- 
ing stage by bleeding, diaphoretics, &c. We may antici- 
pate the treatment proper during the intermission in this 
stage, bv combining our diaphoretics with mercurials. 
Where the determination to the brain is alleviated if it ex- 
tending to produce sleep, and promote the sweating stage. 
In the intermission, mercurial cathartics will be proper, un- 
less mercury has been combined with the diaphoretics du- 



indicated. Whenever the stomach and bowels, and secre- 
tions of the liver indicate a more healthy action, and the in- 
termission is pretty well established by the reduction of in- 
flammatory action, we should administer cinchona or its ac- 
tive preparations, with or without opium, which in many 
cases is a useful adjuvant, with a view of breaking op the 
paroxysms. 

In the congestive form it may be necessary to ad- 
minister quinine, and other febrifuge tonics before we can 
have time to prepare the system by cathartics, Sec. Other 
remedies may also be used, among which arsenic stand? 
prominent: and it is thought by some that when the par- 
oxysms are broken up by arsenic that they are less liable to 
recur. 

Y\ hen visceral obstructions, and other sequelse occur, they 
should receive their appropriate treatment/ 

Remittent Fever. 

Is thero any essential or radical difference between re- 
mittent and intermittent fever? There is not; but from their 
running a different course, a modification of treatment be. 
comes necessary. 



288 



PRACTICE OF MEDICINE. 



What are the symptoms? Languor, drowsiness, pains in 
the head and back, slight chills, anorexia, tongtie covered 
with a brownish fur, nausea, skin dry and hot, thirst, and 
the pulse is irritated. The febrile excitement abates but 
not so as to amount to a state of apyrexia; this remission 
lasts a short time; the febrile excitement again rises until 
it acquires its former 'violence or exceeds it; which after a, 
certain period again abates, and forms the remission. The 
grade of violence of these exacerbations_vary much in dif- 
ferent cases, and different latitudes. 

What are the indications to be fulfilled in the treatment? 
They are to moderate febrile reaction; to remove from the 
alimentary canal vitiated and irritating secretions; to re- 
move gastro-intestinal irritation, and restore the healthy 
functions of the liver and alimentary canal. 

How may these indications be fulfilled? The first by 
blood-letting in many instances, cathartics, diaphoretics, 
cold applications, and revulsives. 

Cathartics to the extent indicated may fulfil the seeorrcL 

And the mercurial preparations, cupping, blisters, &c, 
are of essential service in the third indication. When the 
system is properly prepared, quinine given during the re- 
missions will often break up the paroxysms, and it may fre- 
quently be combined with diaphoretics, particularly with 
the sweet spirits of nitre, and given when the febrile symp- 
toms would preclude its use alone. 

Yellow Fever, 

How is yellow fever divided? Into inflammatory,, adyn- 
amic, and congestive or malignant,. 

What are the symptoms ? As premonitory, generally there 
is depressed mental energy, low spirits, slight chills, nausea., 
pain in the loins and back, giddiness, &c. In the regular 
attack there is occasionally shivering, but generally the 
premonitory symptoms are succeeded by great excitement, 
severe pain3, and cramp. The eye is swelled, dejected, 
moistened with tears, and has a dull, heavy, drunken ap- 
pearance. 

The skin is flushed^ dry, and hot; the pulse is accelera- 
ted, and generally full, soft, an=d compressible ; the bowels, 
are variable; the respiration is hurried, usually nervous,, and 
attended with sighing. 



T'RA'CTlCE OF MEDICINE. 289 

*fhis state of excitement is followed sooner or later by 
(collapse and yellow hue of the skin and conjunctiva; ana 

¥he symptoms vary very much in different cases, how- 
ever. , , 

What aro the indications in the treatment? 1 o subdue 
the inflammatory and irritated condition of the system, both 
local and general; to prevent the state of collapse; and when 
the inflammatory state of the system is subdued to sustain 
the powers of the system. 

Continued Fever. 

What is continued fever?- It is a fever without intermis- 
sion, and when remission exist! it is scarcely perceptible, 
and of very short .duration. 

How is" continued fever divided ] Into synocha, syno- 
chus, and typhus. 

What is understood by synocha? It embraces all those 
fevers which are violently inflammatory. 

What are its symptoms! There is hardness, quickness, 
and tension of the pulse. 

What is understood by synochus? It is a grade of fever 
between synocha and typhus ; and occurs more frequently 
than any o'ther in the intermittents and remittents of our 
climate. It indicates a grade of excitement, and not a dis- 
tinct disease. 

What is understood by typhus?- There is a lower grade 
of fever and a proneness to sink. 

What are its symptoms? A small, weak, quick, and fre- 
quent pulse; with great disturbance of the sensorial powers, 

Typhoid Fever. 

What other name is sometimes given to typhoid fever? 
Dothinenteritis. 

What are the symptoms? In the first stage there is pros- 
tration more than proportionate to the local symptoms, dul- 
ness of intellect, cephalalgia, wandering pains in the back 
and limbs, dizziness, sometimes cpistaxis, diarrhoea in about 
half the cases, anorexia, chilliness, and irregular fever. 

In the second stage there is an increase of the cerebral 
symptoms, dullness of hearing, tinnitus, often delirium; in- 
crease of fever, dryness of the skin, diarrhoea, pains in the 
abdomen with tenderness, especially at epigastrium and 



PRACTICE OF MEDICINE, 



right and left iliac regions, tympanitis, enlargement of 
spleen, anorexia, eruption of rose colored papulae on the ab- 
domen and thorax, sudamina, cough, and sibilant rhonchus. 

When^the prognosis is favorable the third stage is char- 
acterized by the symptoms of the second stage with a grad- 
ual diminution about the end of the second week and con- 
valescence at the end of the third. If unfavorable, there is 
sordes on the teeth, stupor, coma, muttering delirium, great 
prostration, diarrhoea, increased at times, with discharges of 
blood, and rigors, 

What is the pathological anatomy of this disease? Thore 
is a thickening and secretion of whitish matter into the 
glands of Peyer and their sub-mucous tissue. Tho mesen- 
teric glands are enlarged, and the spleen softened slightly. 
In the second stage there is increased alteration of the 
glands of Peyer, as well as injection and commencement of 
ulceration in the adjoining mucous tissue; softening and 
thickening of the mesenteric glands and spleen. Sometimes 
there is an inflamed state of the bronchial mucous mem- 
brane, gastritis, and softening of the mucous membrane of 
the large intestine. There is also usually injection of the 
membranes of the brain or effusion of serum, but never suf- 
ficient to explain the violence of the cerebral symptoms. In 
the third stage the glands of Peyer are ulcerated: the ulcers 
have irregular excavated edges; sometimes the ulcers are 
preceded by distinct yellow sloughs in the second and, third 
stages; the mucous membrane around them is reddened but 
not much altered in consistence. The mesenteric glands 
are softened, reddened, and often infiltrated with purulent 
matter. Pneumonia is often present. 

Can typhoid fever be cut short abruptly by treatment] 
No; the main object of treatment is to prevent or remove 
local inflammations, which cause the greatest uneasiness to 
the patient, and are often the immediate cause of death. 

What is the treatment] In mild cases but little should 
bo done. A small bleeding, with diluonts, acids, and neu- 
tral and effervescing draughts are generally all that is re- 
quired. 

When there are symptoms of cerebral determinations, 
cups, leeches, or cold applications will bo useful ; if diar- 
rhoea, opiate enemata will be proper. If pneumonia attend 
cupping and leeching the chest will be proper. In the lat- 
ter stages the sulphate of quinine and nutritious diet will 



PRACTICE OF MEDICINE, 



be proper if the powers of the system fail. If the secre- 
tions from the bowels ore much altered mild cathartics will 
be proper, with which the bowels should bo kept open if 
necessary. 

What are the complications? There may be perforation 
of the intestine and its consequences. Undue determina- 
tions to the various organs. Tuberculous disea.se in the 
last stage. When epidemic it is very violent, and appears 
to be sometimes contagious. 

Those various complications, and circumstances require 
corresponding modifications of treatment. 

Typhus Fever. 

In what prominent particulars does typhus differ from ty- 
phoid fever? It is usually epidemic, manifestly contagious; 
the pains in the hoad, back, and limbs more severe; the le- 
sions after death more variable; and no constant alterations 
&a in typhoid fever. 

What are the symptoms? In addition to the above symp- 
toms there is occasionally epistaxis; nervous symptoms with 
profound stupor ; dull suffusion of the eyes; petechial erup- 
tion (of a purplish tint in severe cases) "towards the end of 
the first week, extending nearly over the whole body, neith- 
er so bright or prominent as in dothinenteritis. Sudamina 
are sometimes present although not so frequently as in ty- 
phoid fever; pulse frequent, and commonly soft; cough with 
mucus and sub-crepitant rhonchus in the lungs, with feeblo 
respiration; percussion often dull at the same part from con- 
gestion; and a change is generally found in the appearance 
of the blood after death, with frequently a softened state of 
the solids. 

What ia the treatment? There is no specific treatment; 
the symptoms should bo watched, and local congestions and 
determinations obviated by appropriate treatment, and by 
this means we can usually mitigate the severity of tho at- 
tack. Sponging with chloride of soda in solution, and the 
use of cool acidulated drinks are beneficial. When the fe- 
ver declines, tonics and wine are proper or'^when there is 
great prostration. Gentle purgatives are -called for; and the 
saline diaphoretics are useful, especially the acetate of am- 
monia, 



PRACTICE OF MEDICINE. 



Inflammation of the Alimentary Canal and Accessary 

Organs. 

Glossitis. 

What is glossitis'? Inflammation of the tongue. 

What are the symptoms'? A burning and throbbing pain 
in the tongue with a synochal grade of fever. The tongue 
becomes hot, dry, red, swollen, and with a sense of impend ■ 
ing suffocation. It terminates sometimes in suppuration, 
and occasionally in mortification of a portion of it. 

What is the treatment? Bloodletting decisively practic- 
ed, leeches to the lower jaw and tongue, incisions into the 
substance of the tongue along its middle, and blisters to the 
back of the neck. Tracheotomy may also become neces- 
sary. 

Of Tonsillitis or Quinsy, 

What is tonsillitis, and what are the symptoms '? It is an 
inflammation of the tonsils. It is known by slight chills 
succeeded by a high grade of fever, and more or less pain 
in the fauces on swallowing. In a short time the pain be- 
comes fixed, deglutition nearly or quite impossible, and one 
or both tonsils much swollen. The face is tumid and red, 
the carotids beat violently, and the respiration is difficult. — - 
It generally terminates either in resolution or suppuration. 
It is caused mostly by cold and damp air, or suddenly check- 
ed perspiration. 

What is the treatment? Vigorous antiphlogistic treat- 
ment should be adopted by general and local bloodletting, 
scarification of the tonsils, purgatives, and antiphlogistic 
diaphoretics. 

When suppuration takes place it should be opened. 
Parotitis or Mumps. 

What is parotitis, and its symptoms ? It is an inflamma- 
tion of the parotid gland known by slight febrile symptoms, 
a feeling of stiffness in the jaws, and swelling and pain in 
one or both parotids. 

What is the treatment? Keep the bowels open, and use 
mild diaphoretics, The parts should be kept warm, and 
avoid taking cold. If the inflammatory symptoms are vio- 
lent the antiphlogistic course should bo adopted. Should 



PRACTICE OF MEDICINE. 



293 



the testicles become affected a blister should be put on the 
parotids. 

Of Acute Gastritis. 

What is gastritis, and what are the symptoms'? It is an 
inflammation of the mucous membrane of the stomach, at- 
tended mostly with vomiting and a burning lancinating pain 
in the stomach. There is a desire for cool drinks, and an 
aversion to warm which aggravate the complaint. The 
pulse is small, tense, and quick; the pain is constant except 
lor a moment after taking a cold drink ; tho patient gener- 
ally lies on his back, and moves as little as possible. 

What are the causes'? Cold water rapidly swallowed, 
irritating and corrosive substances, fatiguemg exercise, over 
distention, improper food, metastasis of gout or rheumatism, 
injuries, and miasm of some kinds. 

What is the treatment? Bleeding, general and loca', 
blisters over the stomach, mild mucilaginous drinks, weak 
lemonade or orangeade, laxative enemata, and after the 
phlogistic state of the system has been moderated, opium is 
beneficial in allaying the pain and vomiting. In convales- 
cence great care is required in avoiding improper food. 

Chronic Gastritis. 

What are the symptoms? They are very similar to the 
acute form, only less violent and long continued, with dis- 
ordered action of all the functions of the stomach. 

What is the treatment? It may be treated on the same 
general principles as the acute. 

Acute Enteritis. 

What is it, and what are the symptoms? It is an acute 
inflammation of tho alimentary canal, affecting the perito* 
noal and muscular coats, or mucous membrane, 

What are the symptoms when the peritoneal coat ir in- 
flamed ? An aching or burning pain about the umbilicus, 
obstinate constipation, unless the inflammation extends to 
the mucous membrane, in which case dysenteric discharges 
take place; nausea and vomiting, dry tongue, urgent thirst, 
and hot skin. The patient lies on his back with the knees 
drawn up, and shoulders elevated, with a tumid abdomen 
from flatus. Its course is rapid, and prone to terminate in 



PRACTICE OF MEDICINE. 



gangrc.no, in which event the pain subsides suddenly, the 
pulse sinks, the countenance becomes pale, the extremities 
cold, slight delirium, and sometimes convulsions attend. — - 
It generally terminates either in resolution or death, by the 
eighth da} 7 . It is distinguished from pleuritis and hepatitis 
by a contracted, corded, quick, tense, and frequent pulse; 
and by the regular and strong action of the thoracic respi- 
ratory muscles ; neither of which exist in the other affec- 
tions. It may be regarded as a dangerous disease 

What are the causes?- Indurated fceces, spasm, injuries, 
purgatives, hernia, cold, metastasis, &c. 

What is the treatment? Prompt blood-letting, leeching, 
mild purgatives, opium in the advanced stages, blisters, and 
mild mucilaginous diluents. 

What are the symptoms when the mucous coat is inflam- 
ed? When the small intestines are affected there is some 
pain in the umbilical region, more or less nausea and vom- 
iting, and the pulse is corded; the tongue is white or of a 
light brown; the bowels are loose or easily moved. 

What is it called when the colon and rectum are the seat 
of the inflammation] Dysentery. 

Dysentery. 

What are the symptoms? It is often, ushered in by the 
ordinary symptoms of remittent fever, pain in the bowels, 
costiveness, or diarrhoea, followed by frequent mucous and 
bloody stools, tormina, and tenesmus, with a retention of 
the natural feces. Tenesmus is one of the most constant 
and characteristic symptoms of this disease. The violence 
of the symptoms is a pretty good criterion of the danger of 
the disease. 

What are the causes? Atmospheric vicissitudes, and 
k g ; n o - m i a s m a t a . 

What is the prognosis when the discharges consist almost 
entirely of blood at the commencement? More favorable 
than when composed of mucous tinged with blood. 

What is the treatment? The indications are to moderate 
the excessive reaction of the heart and arteiies, to restore 
the healthy action of the liver and skin, and to subdue the 
local inflammation of the bowels. 

Whenever the pulse is firm and quick, or tense and fre- 
quent, blood may bo drawn. Purgatives judiciously man- 
aged are beneficial; castor oil, and calomel, are among the 



PRACTICE OF MEDICINE. 295 



best. Diaphoretics, us Dover's powder combined with cal- 
omel, and followed by a laxative, are beneficial. Opium, 
sugar of lead, blisters, and anodyne enemeta are all ben- 
eficial. 

Chronic Enteritis. 

What are the symptoms'? There is pain, and a sen;;e of 
soreness felt on coughing or sneezing, languor, and weak- 
ness; the pulse is small, weak, and sharp, or corded; the 
hands and feet cold, flushed cheeks, and a burning in the 
palms and soles; pain after eating, diarrhoea, digestion is 
imperfect, and there is tormina. The discharges are slimy 
and bloody, or watery and profuse, and there is emaciation. 

What are the causes ) It may be a consequence of the 
acute form, but it much more frequently results from crude 
Indigestible food, and other irritants applied to the bowels, 
or from, atmospheric vicissitudes. 

What is the treatment ? Regulation of the diet is impor- 
tant and indispensable. Farinaceous diet such as arrow 
root, oat meal, barley, tapioca, rice and sago should be used, 
animal food and solids are generally inadmissible. Mild 
laxatives are to be used carefully. Leeches applied to the 
abdomen are also useful. Emulsions of copaiva, spirits of 
turpentine, and mucilaginous drinks maybe used. 

Of Acute Peritonitis. 

"What are the symptoms? It is ushered in by chills, pains 
in the limbs, &e. There is pain in the abdomen, and in all 
cases external pressure on the surface of the abdomen is 
very painful. The patient lies on the back with his feet 
drawn up, and shoulders elevated. 

What are the causes? Mechanical injuries, violent ex- 
ertions, perforation of the stomach and its consequences, 
parturition, metastasis, &c. 

What is the treatment? The most important measure is 
decisive bloodletting, general and local; with the applica- 
tion of poultices, and revulsives. 

Purgatives, of which a good one is castor oil, combined 
with' spirits of turpentine, are beneficial. Large doses of 
opium alone or combined with calomel are also employed. 

Of Acute Hepatitis. 

What are the symptoms? Pain in the right hypochon- 



296 



PRACTICE OF MEDICINE. 



drium, a sensation of tightness across the abdomen, difficult 
respiration, the body inclined forwards, the pain extending 
to the clavicle and shoulder of the right and left side. — - 
Pressure over the liver, and an attempt to iie on the left 
side produces pain. There are general febrile symptoms, 
costiveness, and a scalding in passing urine. 

What are the causes'? Miasm, atmospheric vicissitudes, 
injuries, metastasis, &c. 

What is the treatment? Blood-letting general and local, 
mercurial cathartics, antimonials, diaphoretics, cupping, 
blisters, and nitro-muriatic acid. 

Chronic Hepatitis. 

What are the symptoms? When it is not the consequence 
of an acute attack it begins with disorders of the digestive 
functions; there is pain and tenderness over the region of 
the liver, and a dry harsh constricted state of the skin. 

What is the treatment? Sometimes leeches are proper, 
and mercury is considered indispensable. Nitro-muriatic 
acid, blisters or other revulsives, and low diet are beneficial. 

Of Inflammations of the Nervous System. 
Cephalitis, 

What are its varieties? They are meningitis and cer- 
ebritis. 

How is meningitis divided? Into phrenitis when there 
is inflammation of the pia mater; and arachnitis when the 
arachnoid membrane is affected. 

Phrenitis or Phrensy. 

What are the symptoms of phrenitis? A sense of full- 
ness in the head, generally nausea or vomiting, pain and fe- 
brile reaction increase, the eyes become flushed and spark - 
liug, and delirium ensues. The pulse is firm and active 
with a disturbed respiration. 

What are the causes? It is seldom idiopathic, but com- 
monly occurs during the. progress of fevers. ' 

Its exciting causes may bo violent passions, insolation, 
the influences of cold, drunkenness, metastasis, &c. 

What is the prognosis? It is attended with great dan- 
ger, and this is generally in proportion to the violence and 
obstinacy of the symptoms. 



PRACTICE OF MEDICINE. 



What is the treatment? A \igorous antiphlogistic course 
is promptly demanded by blood letting general and local, 
ice to the head, purgatives, antimony, nitre, digitalis, &c. 

Ar admits. 

What is this commonly called ? Acute dropsy of the 
brain, or acute hydrocephalus. 

At what period of life does it generally occur? During 
dentition. 

What are the symptoms? Wakefulness, irritability of 
temper, repugnance to light, pain in the head, restlessness, 
an irritated, quick, tense and active pulse, torpid bowels, 
retching and vomiting, delirium, dry skin, dilated or con- 
tracted pupils, somnolency, coma, strabismus, and paralysis 
or convulsions. 

What are the post mortem appearances? Injection or 
thickening of the membranes, and an effusion of serum. 

What are the causes? Hereditary predisposition, blows, 
falls, insolation, metastasis, dentition, intestinal irritation, 
and whatever may produce a determination of blood to the 
brain. 

What are the indications of treatment? To moderate 
arterial action, to remove the congested and inflammatory 
state of the brain, to remove the causes of irritation. To 
fulfil these, blood-letting general andl ocal, purgatives con- 
taining calomel, ice to the head, and blisters, are among the 
most useful means. The diet should be simple and un- 
irritating. 

Cerebritis or Ramollissement of the Brain. 

What are the symptoms ? It has M been divided into two 
periods, with symptoms peculiar to each. In the first there 
is fixed and violent pain in the head, which may continue a 
long time, vertigo, obtuseness and confusion of intellect, 
loss of memory, and indifference to surrounding objects. — 
The pulse is often full and hard. 

In the second there may be gradual or sudden paralysis 
of one limb or half the body, and difficulty of speech; 
eoma sometimes occurs, followed by convulsions, which 
leaves a contracted state of the flexor muscles of the limbs, 
or rigidity, which has been considered as peculiar. 

What is the treatment? General and local blood-letting, 
active cathartics, blisters, and mercury. 

•26 



PRACTICE OF MEDICINE, 



Of Inflammation of the Respiratory Organs. 
Pneumonia, 

What is understood by pneumonia? It is an inflamma- 
tion of the substance of the lung. 

What are the characteristic symptoms? Pain in the chest 
with fever, accelerated and oppressed breathing, cough, with 
a viscid and rust colored expectoration. There is the crep- 
itant rhonchus at first, followed by the bronchial respira- 
tion. 

How are the stages of pneumonia divided? Into four. 

What are their anatomical characters? In the first there 
is sanguineous congestion or engorgement of a red appear- 
ance, but still it will crepitate. 

In the second there is red hepatization, the lung sinks in 
water, and the color is not uniform, but when torn it exhi- 
bits fine granular points of the size of a pin head. 

In the third there is suppuration or yellow hepatization, 
this suppuration is diffused in the form of purulent infiltra- 
tion, and rarely assumes the form of a distinct abscess. 

In the fourth there is gangrene in which the parenchyma 
is softened down. 

What are the physical signs of these stages? In the first 
there is crepitant rhonchus; as it progresses there is dulness 
on percussion, some degree of bronchial respiration, and vo- 
cal resonance. 

In the second crepitation an 1 vesicular respiration cease, 
and the only sounds are those produced by the air and voice 
in the larger tubes, which are very loud, and are bronchial 
respiration, and bronchophony. There is pretty complete 
flatness on percussion, and the lung does not expand. 

In the third the physical sounds are the same, until the 
effused matter begins to liquify, and then there is mucous 
rhonchus. 

In the fourth there is added to the signs a putrid fetoi in 
the matter expectorated as well as in the breath, together 
with sub-crepitant and mucous rhonchus, passing into gui- 
gling and poctriloquy. 

What are these signs as the inflammation abates? The 
crepitation and resonance return. 

W r hat are the varieties and complications of pneumonia ? 
Typhoid pneumonia, pneumonia complicated with bronchitis, 
and pie u ro-pneumon ia . 



PRACTICE OF MEDICINE. 



What is understood by typhoid pneumonia? It fe when 
pneumonia is attended by low adynamic fever from any 
cause, and the inflammation is rather of a congestive than 
of an inflammatory character. 

What is understood by pleuropneumonia? It is where 
pneumonia is complicated with pleurisy, and the symptoms 
are modified by effusion, 

What is the prognosis of pneumonia? It is a serious dis- 
ease; more dangerous, the further the disease advances, and 
the greater its extent and complications. 

At what period does death usually occur? About the be- 
gining of the third stage. 

What aro the causes? All causes which tend to produce 
asphyxia, violent exertion, atmospheric vicissitudes, and 
exposure, diseases of the heart, bronchitis, wounds, tu- 
bercles, and foreign bodies. 

What i3 the treatment? In the first stage bloodletting, 
general and local, repeated if necessary, tartar emetic, mer- 
cury and opium, after bleeding. 

In the second stage, mercury and opium are appropriate 
remedies; with external irritation by blisters; and expecto- 
rants containing an alkali. 

According to the grade of action we may give digitalis, 
squill, &c, or senega, camphor, and carbonate of ammonia, 
as indicated. Hydriodate of potassa with senega or sarsa- 
parilla will hasten absorption in convalescence. 

In the third stage antiphlogistics are not to bo used, and 
if remedies are used at all they should bo of a stimulating 
kind, such as carbonate of ammonia, ether, ca rnphor, seno- 
ga, wine, &c. 

In the fourth stage unless the general symptoms centra- 
indicate its use, wine, quinine, &c, must be administered. 

What is the treatment of the typhoid pneumonia? Gen- 
eral bloodletting is not admissible; but local may be. Dry 
cupping, blisters, sinapisms, calomel and opium, with stim- 
ulants. 

In ihe other complications the treatment does not differ 
much from ordinary cases of pneumonia, and requires a cor- 
responding treatment modified by the state of the general 
system. 

What is the disease commonly termed bilious pneumonia! 
It is simply pneumonia complicated with a deranged con- 
dition of the liver. 



V 



300 PRACTICE OF MEDICINE. . 

What kind of pneumonia usually attacks children? 
Lobular pneumonia; the anatomical character of which is 
diffusion of inflammation through several scattered points 
at the same time, and usually affects the posterior part of 
the lung. 

What are the symptoms? The respiration is rough, there 
is generally mucous and sub-crepitant rhonehus, the respi- 
ration only becomes bronchial at the latter stages of the dis- 
ease ; there is also dullness on percussion. 

What is the treatment? The position of the child should 
be changed frequently, and kept in a uniform temperature. 
Local bleeding in the commencement, counter irritants, and 
ipecacuanha internally, are valuable; or if the child be 
strong and robust, tartar emetic may be given. 

Remedies to be of use should be persevered in. 

Pleurisy or Pleuritis. 

What is understood by pleurisy ? It is an inflammation 
of the pleura. 

What are the characteristics of this disease? A sharp pain 
in the side, diminished resonance of the side, a [friction 
sound, with regophony, followed by enlargement, and ab~ 
sence of respiration and voice in auscultation. There is 
always effusion. 

How may wo classify the products of pleurisy, or the mat- 
ter which is effused in acute and chronic pleurisy ? Into 
two classes : — Those in which absorption predominates over 
effusion, and the liquid is removed; and those in which the 
effusion predominates, and the liquid can only be removed 
through a perforation of the pleura. 

W 7 hat are the signs of absorption? The side becomes 
contracted, and from being larger than the other side be- 
comes smaller. In some cases after a time there may be a 
weak respiratory murmur, slight resonance on percussion 
and of the voice. 

What is generally the character of tho fluid when effu- 
sion predominates? It is purulent; and constitutes the em- 
pyema of authors. 

What are the signs? The same as those characteristic of 
liquid effusion modified by the length of time that effusion 
continues. Rigors, hectic fever, &e. may exist; which when 
;hey do, are indicative of a purulent effusion. 



PRACTICE OF MEDICINE. 



What is the prognosis in pleurisy ? It is dangerous when 
neglected; but when simple." and remedies are promptly em- 
ployed before the effusion is copious it generally yields rea- 
dily. But when it is complicated with tubercles or it be 
comes chronic it may be fatal. 

What are the indications in the treatment of pleurisy? 
To subdue inflammation; to promote the removal of its pro- 
duct; and in chronic cases to improve the state of the gene- 
ral health. 

What are the means used for these objects? In the first 
stage full general bleeding to the extent of removing all 
pain on full respiration, or the hardness of the pulse is sub- 
dued; local bloodletting followed by a poultice, or hot, dry 
napkins, a repetition of the bleeding if necessary, brisk 
purgatives containing mercury and antimony; tartarized an- 
timony alone, and blisters are useful. Then mercury, digi- 
talis, colchicum, alkalies, &c, will be useful to fulfil the 
second indication, and to still further assist in reducing in- 
flammation. The patient must use light diet, and remain in 
bed while there are acute symptoms. 

To fulfil the third indication when the pulse is weak, or 
the fever hectic, a nutritious and tonic plan must be pur- 
sued so far as thoy are not contra-indicated by other symp- 
toms. Counter irritation should be used now as well as pre- 
viously, and the preparations of iodine internally and exter- 
nally are very useful. Diuretics are also often indicated. 

Is the operation of paracentesis thoracis advisable? It 
may be in some cases; for instance wliere thore is a sudden 
effusion threatening suffocation or where there is an old ex- 
tensive effusion increasing constantly, and showing no dis- 
position to be absorbed; but the propriety of the operation 
is questionable, except in a very small proportion of cases. 

Where should the opening be made? When the abscess 
points, there is no choice, this must be the part; in other 
cases, the intercostal spaces between the third and seventh 
ribs. The fluid should be drawn off at successive times, 
the orifice closed in the intervals, and the admission of air 
prevented. 

What connection has pleurisy with tubercles? It may 
be a cause or a mere sign of their presence, and should 
therefore be closely watched until conducted to a full con- 
valescence. 

26* 



302 PRACTICK ok MEDICINE. 

Laryngitis . 

What is laryngitis ? An inflammation of the sub-mucous 
cellular membrane of the larynx. 

How is it divided ? Into acute and chronic. 

Acute Laryngitis. 

What are the varieties? Sthenic and asthenic. 

What are the symptoms of the sthenic form ? Difficulty 
of swallowing, with high fever, preceded by rigors, hoarse- 
ness, husky convulsive cough, tenderness, pain, and con- 
striction in the larynx; and difficult, prolonged, sonorous in- 
spiration. The fauces are generally red ; by pressing the 
tongue downwards the epiglottis may be seen erect, thick- 
ened, and of a bright red color. As the disease progresses 
the countenance becomes anxious, the lips livid, the eyes 
staring and watery, the voice reduced to a whisper, and the 
pulse is reduced and unequal. The patient then becomes 
enfeebled, delirious, comatose, and dies. 

What are the symptoms of the asthenic? It differs from 
the sthenic in the absence of inflammatory symptoms and 
fever; and sometimes of pain and difficulty of deglutition. 

What are the causes of acute laryngitis? Exposure to 
cold and wet, tonsilitis, swallowing scalding or corrosive 
liquids, &c. 

What are the anatomical characters? A red injected 
and thickened state of the lining membrane. 

What is the prognosis. It is the most fatal of all inflam- 
mations. 

What is the treatment? In the sthenic form a most 
prompt and energetic antiphlogistic course should be adop- 
ted, by bleeding, calomel, and antimony, before effusion 
takes place. 

Salivation should be attompted and brought about as 
soon as possible. Bronchotomy must be resorted to, if our 
other remedies fail, and the state of breathing requires it. 

In the asthenic form mercury must also be used, but de- 
pletion is not allowable, except locally; blisters and other 
revulsives may be used. These failing, and other symp- 
toms requiring it, bronchotomy should be resorted to. 

Chronic Laryngitis. 

What are the symptoms? It is more frequent than the 



PRACTICE OF MEDICINE. 



acute, exists in various degrees, and is known by hoarseness, 
a husky dry cough, with soreness or pain in the larynx on 
pressure. 

What are the anatomical characters?- Redness and thick- 
ening of the mucous membrane, contraction of xhe liga- 
ments, fibrous degeneration, wasting of the muscles, and 
ulceration. 

What is the prognosis?- Slight cases are often curable. 

What are the indications of treatment?- To subdue chro- 
nic inflammation, and remove its effects; to relieve urgent 
symptoms, and improve the general health. 

The parts should be kept at rest, and protected from dust, 
cold air, &c, leeching, blisters, a mild mercurial course, hy- 
driodate of potassa, and the application of nitrate of silver, 
sulphate of copper, dee., cither in solution or powder to the 
larynx internally are recommended. 

It is often connected with phthisis, either as a cause or 
complication. 

Cynanche Tracheaiis, Tracheitis, or Croup. 
What are the symptoms?- At first there are catarrhal 
svmptoms, hoarseness, &c; then stridulous respiration, a 
peculiar rough barking and ringing cough, with hisfh fever; 
these symptoms are followed by general failure of the vital 
powers, with an increase of the unfavorable symptoms, livi- 
dity, suffocation, &c. It varies in intensity in different 
cases. 

What are the anatomical characters? Redness of the mu- 
cous membrane, continuous or in patches; the sub-mucous 
tissue is swelled, and in advanced stages when there is 
sthenic action there is an effusion of a grey white albumin- 
ous matter, forming a false membrane having the shape of 
the trachea. 

What are the causes? Exposure to cold and damp; and 
to humid ill ventilated places. It occurs from one to six 
years of age. 

What is the prognosis? It is a serious disease; and if 
not quickly arrested by treatment soon terminates fatally. 

What is the treatment? The indications are to diminish 
inflammatory action, and its consequences; to procure the 
discharge of such matters as are produced in the trachea; to 
subdue spasmodic action; and in the latter stages to support 
the powers of life. 



304 



PRACTICE OF MEDICINE. 



At the first invasion an emetic of tartar-emetic or ipecac, 
is the best remedy; and in slight cases it will cut short the 
disease, particularly if followed by a warm bath, calomel, 
Jan es' powder, and castor oil. 

If the fever runs high, free blood-letting, soon after the 
administration of an emetic, which will assist its action; 
cupping, calomel, tartar-emetic, blisters, <^c, are indicated. 
In the last stages where collapse has supervened, stimulants 
and cordials must be used, and anti-spasmodics in the spas- 
modic form. 

Acute Bronchitis. 

How is it distinguished? By the terms sthenic and 
asthenic. 

What are the symptoms of the sthenic form'* Marked in- 
flammatory action^, pain, constriction across the sternum, 
severe cough, with glutinous expectoration, high fever, and 
hurried breathing. The rhonchi are at first sibilant and so- 
norous, afterwards mucous and sub-mucous, with weakened 
respiratory murmur, and a clear sound on percussion, show- 
ing the vesicular structure free from disease. If not arrest- 
ed it may become complicated with inflammation or con- 
gestion of the lungs, asphyxia, and death. 

What are the symptoms in the asthenic form? The chief 
difference is in the symptoms of depression, with gastric 
derangement, great oppression of breathing, and mucous 
rhonchus in the early stages. It is almost peculiar to old 
people, persons in delicate health and young children. 

What are the causes? Cold and moisture, variable at- 
mosphere, and eruptive fevers. 

What are the anatomical characters? A red color and 
thickening of the mucous membrane, with a frothy or pur- 
ulent fluid in the bronchiae. 

What is the prognosis I It must be determined by the 
extent and stage of the disease, and the general condition 
of the patient. 

What is the treatment? When sthenic, bleeding general 
and local, according to the condition of the patient, a pur- 
gative of calomel, small doses of tartar-emetic, tincture of 
digitalis, wine of colchicum, &c, will contribute to roduce 
tho inflammation, and hasten its termination by expectora- 
tion. Revulsives to tho chest are also useful. When there 
is a free secretion blisters and stimulating expectorants are 



PRACTICE OF MEDICINE. 



305 



proper; and if a state of collapse comes on we must stimu- 
late actively with carbonate of ammonia, camphor, &c. In 
the asthenic form depletion cannot be carried to much ex- 
tent. Leeches, dry cupping, and blisters should bo used, 
with small doses of mercurials and antimonials or ipicac, 
with a decoction of senega, squills, &c. In young children 
emeties and mercurials are useful in bronchitis. 

Ch ron ic Bronchitis, 

Are acute and chronic inflammations of the air passages 
separated by a well defined line? They are not; the chronic 
are distinguished however by the continued presence of 
opaque matters in the expectoration, such as arc classed un- 
der the head of albuminous. 

What are the symptoms of chronic bronchitis? Expec- 
toration, varying in different cases; when purulent, there 
may be hectic and night sweats like pulmonary consump- 
tion, but the physical signs are wanting; the chest expands 
well, and sounds well on percussion, and there are the va- 
rious rhonchi which are continually shifting and changing. 

What are the causes? Repeated attacks ot the acute, 
breathing impure air loaded with irritating particles, &c. 

What are the anatomical characters? The mucous mem- 
brane is of a deep red color generally, sometimes however 
paler than natural, where there lias been copious purulent 
expectoration; ulceration is not a common occurrence un- 
less there has been an habitual inhalation of dust. 

What is the treatment? Counter-irritants, expectorants, 
and anodynes, with a close attention to the general symp- 
toms. In those predisposed to this disease sponging the 
body with cold water, and vinegar and salt, is useful. Th 2 
body shoulJ also be well protected by a flannel or leather 
jacket. 

Phthisis PvJmonalis, or Pulmonary Consumption. 

What form of disease is included under these terms? 
All diseases of the lungs dependant on tuberculous matter, 
or depositions and indurations allied to it. 

What are its general characteristics ? Cough, at first with 
little expectoration, sometimes haemoptysis, as the disease 
progresses the expectoration becomes opaque, purulent, and 
copious, fever, quick pulse, night sweats, dyspnoea, emacia- 
tion and debility. The principal physical signs are irrogu 



300 



PRACTICE OF MEDICINE, 



iar expansion of the chest, dullness on percussion, with 
more or less bronchial respiration, and bronchophony in 
the upper parts of the chest, followed by cavernous rhon- 
ehus and respiration, and pectriloquy, which indicate more 
or less consolidation of the lung, succeeded by cavities 
communicating with the bronchia. 

What are the anatomical characters] They may be ar- 
ranged under the following heads : — 

1st. The miliary granulations or tubercles, which are a 
number of little hard bodies of a semi-transparent, reddish 
drab, or skin color, or sometimes of a grey or ash color, gen- 
erally in clusters. 

2nd. A consolidation diffused through the pulmonary tis- 
sue without particular shape, varying in consistence, some- 
times hard, and somewhat semi-transparent, resembling the 
miliary granulations, but generally darker. 

3d. Opaque yellowish white masses; some are nearly 
solid, and others have a cheesy consistence. Tuberculous 
matter is frequently found diffused through the pulmonary 
texture, which is the infiltrated tubercle of Laennec. All 
these conditions tend to passinto-a softened fluid state, form 
vomica?, and leave the next form of lesion. 

4th. Cavities or excavations various in number, form, and 
size, containing more or les3 tuberculous matter, liquid pus 
alone or tinged with blood, mucous, a mixture of all these, 
or empty. They communicate with the air tubes, and often 
with each other; their sides are composed of consolidated 
lung, rough and sometimes sloughy, or of an irregular coat 
of lymph; in others thick, rigid, and of a fibro-cartilagin- 
ous character. These lesions affect the upper and posterior 
more than the anterior lobes, and are often attended with 
various complications, such as bronchitis, pneumonia, &c. 

How is the course of consumption divided? Into three 
stages. The first is that of the formation of the indurations, 
granular or diffused; the second is that of the conversion of 
those into yellow tubercle, and the extension of the lesion; 
the third is that of their softening, evacuation, and the for- 
mation of vomicae. 

What are the symptoms of the first stage ? flacking 
cough, either dry, or with thin and transparent expectora- 
tion; sometimes pains in the chest, quickness of the pulse, 
with occasional flushes of fever, terminating in perspiration ; 
more or less dullness on percussion, increased bro'nahophony, 
and bronchial sound on expiration. 



PRACTICE OF MEDICINE, 



307 



What in the second? The symptoms of irritation con- 
tinue, there is languor, loss of flesh, increased pain, generally 
chills, fever, and sweating, more abundant expectoration, 
thicker and sometimes tinged with blood. The mucous and 
submucous rhonchi are heard. There are sio-ns of increased 
density of the lungs, the dullness on percussion is increased, 
ths respiration becomes more bronchial, and the vocal reso- 
nance is increased. 

What are the symptoms in the third stage? The con- 
sumptive symptoms of the last are increased, a copious and 
heterogeneous expectoration of pus, mucus, softened tuber- 
cle, blood, shreds of lymph, and sometimes portions of pul- 
monary tissue; confirmed hectic, occasionally diarrhoea, 
increasing marasmus, &c. Cavernous rhonchus or gurgling 
is heard, followed by cavernous respiration and pectriloquy 
when the cavity is empty; and when it is very large the 
sound is amphoric. The walls of the chest sink and form a 
hollow below one or both clavicles, and there is a defect or 
irregularity in the movements of the chest. The expecto- 
ration is often nummular or with a defined margin and flat- 
tened like money, from which it derives its name. 

Is phthisis a constitutional or a local affection ? It is both 
constitutional and local. 

What are the varieties of phthisis?- They are the acute 
and chronic. 

What are the indications in the treatment of phthisis? 
To diminish the local irritations and congestions that lead 
to the formation of indurations or tubercles: to correct the 
condition of the system which degrades the nutritive pro- 
cess and disposes to the formation of these diseased pro- 
ducts; to promote the removal of those already deposited: 
and to treat troublesome symptoms and accidental compli- 
cations. 

In the first stage, antiphlogistic and counter-irritant reme- 
dies avail most; but depletion should be limited to cases in 
which there is plethora, pulmonary inflammation, conges- 
tion, or hemorrhage. Emetics, iodine, sarsapariila, columbo, 
digitalis, carbonate of iron, pure air, change of climate, and 
exercise, are all useful when properly adapted to the partic- 
ular case, and will, sometimes arrest the disease. The diet 
should be mild and nutritious. 

In the second and third stao-es depletions are less needed, 
and a somewhat tonic plan, with or without counter-irritants 



308 



PRACTICE OF MEDICINE. 



are indicated, with a more generous diet. Mifd cxpecto* 
rants and anodynes are often useful and necessary, and of 
the latter, hyosciamus answers better than opium or its pre- 
parations. Localities protected on their northern and east^ 
ern limits, and facing the south, are to be preferred as resi- 
dences. 

What means may be made use of in the prevention of 
phthisis? Prevent or speedily remove those inflammations 
and congestions which tend to the development of tubercles, 
and of that state of strumous cachexia or imperfect nutrition 
from which they arise. Hereditary predisposition is a prom- 
inent cause, and may be in some measure prevented by 
care in forming matrimonial alliances; intermarriage should 
never take place with families where the predisposition 
exists. 

Attention to residence, food, clothing, exercise, &c. is 
necessary for persons predisposed. The powers of life 
should be maintained in as perfect a manner as possible, 
both by hygienic and remedial means. 

Nephritis. 

What are the symptoms'? Slight chills, fever, pain in the 
loinf- darting down to the ureters, testicle retracted, the urine 
in small quantity, tinged with blood, and frequent desiro to 
pass it. Cold is a frequent cause, also blows, strains, &c. 

What is the treatment? General bleeding, cupping, 
leeching, purgatives, mucilaginous diluents, sinapisms, hot 
applications, &c. 

Cystitis* 

What are the symptoms? Violent burning, lancinating, 
or throbbing pain in the region of the bladder, perineum, 
and sometimes the testicles, with a sense of constriction in 
the hypogastric region, pain from pressure above thepubes, 
and stranguary. 

What is the treatment? The same general course as in 
nephritis. 

Pericarditis. 

What are the anatomical characters? Redness, effusion 
of coagulable lymph, and a serous fluid in the pericardium. 

What are the symptoms? Chills, fever, pain in the region 
of the heart, irregularity of pulse, palpitation, dyspnoea, ij-c. 



PRACTICE OF MEDICINE 



309 



The impulse of the heart is at first augmented, the sounds 
are increased in intensity, and when endo-earditis exists, are 
accompanied by a bellows murmur. On the second or third- 
day a rubbing or rustling sound may often be heard, occa- 
sionally changing to one similar to creaking of leather. The 
impulse of the heart, as well as both natural and morbid 
sounds, decrease with the progress of the effusion, There 
is an increase of fulness of the left side, and dullness on 
percussion is elicited over a larger space than natural, the 
limits of which, define the degree of effusion. 

Chronic Pericarditis is generally only the sequela of the 
acute variety. 

What is the treatment?- Vigorous antiphlogistic remedies 
must be used, such as bleeding, local and general; calomol 
and opium, or calomel and Dover's powders, given so as to 
affect the gums, are important remedies. Diluent drinks, 
with nitrate of potash, tartrate of antimony, absolute repose, 
and emolient applications to the chest are useful. 

Endocarditis. 

What aro the symptoms?- Besides the general symptoms 
oi inflammatory reaction, there is violent action of the heart, 
augmentation of the extent of dullness on percussion, with 
the beat of the heart quite superficial. The most constant 
and characteristic of the phenomena of this disease is the 
bellows murmur. The chronic form may produce indura- 
tion of the valves, and narrowing of the orifices, indicated 
by the bellows murmur, or the rasping, sawing, or musical 
sound. 

Rheumatism. 

How is it divided? Into acute, and chronic. 

What tissue and parts are affected ? The fibrous tissue, 
joints, tendons, and sheaths of muscles. 

W T hat are the symptoms of the acute? Pain in the part 
first affected, then swelling and extension to other parts, 
with fever, sweating, and a pungent odor arises from the 
perspiration. The lever is highest, at night, the pain is in- 
creased by warmth; there is a tendency to effusion, and le- 
sions of the heart mostly occur, which are indicated by their 
own peculiar symptoms. 

At what period does convalescence occur ? Rarely in the 
second week; most generally during the fourth, and often 
not until the sixth week; the pain, fever, and perspiration 

27 



310 



PRACTICE OF MEDICINE. 



thon lessen, the urino is more abundant and loss charged 
with deposit, the appetito returns, thirst diminishes, and the 
pulse becomes natural. 

What are the causes'? Hereditary predisposition, cold, 
and it often occurs without any assignable cause. 

What is the treatment? The principal indication is to 
moderate the fever," bloodletting should be practiced ac- 
cording to the extent of lover and the plethoric state of tho 
individual. Purgatives of calomel and senna, in the early 
stage, followed by nitrate of potash and tartrate of antimony, 
cooling drinks, and opiates at night, are useful. As local 
moans, leeches followed by poultices impregnated with lau- 
danum or decoction of poppy, are useful. After fever has 
subsided blisters should be applied, and repeated when the 
joints are swollen. 

In chronic rheumatism local bleeding, blistering, <^c. are 
useful. Dover's powders, warm bath, hydriodate of potash, 
tartarized antimony, tincture of actea, colchicum, and flan- 
nel bandages have reputation. 

Gout. 

What are tho symptoms ? What is called acute gout gen- 
erally comes on suddenly, by acute pain in the first joint of 
the great too, sometimes it is preceded by chill, fever, and 
restlessness : these symptoms are repeated every night for 
five or ten paroxysms, and subside. The affected part is 
swollen, has a shining appoarance, and on its subsidence tho 
cuticle peels off. It may be considered a constitutional af- 
fection, and depends upon a gouty diathesis, either heredi- 
tary or acquired by rich luxurious living and sedentary 
habits. 

What is retrocedent gout? It is where gout is repelled 
and attacks some internal organ; and many becomo a very 
serious complication. 

What is the treatment? When the system is plethoric, 
diminish repletion by blood-letting. Purgatives are gene- 
rally proper, and colchicum has a deservedly high reputa- 
tion. The diet should be mild and simple. 

Retrocedent gout may be relieved often by hot stimulating 
pediluvia or sinapisms, and the suffering organ must be re- 
lieved according as is indicated by its condition. 



PRACTICE- OF MEDICINE. 



311 



Variola or Small Pox. 

What is the most simple division of small pox? Into dis- 
tinct and confluent; in the former, the pustules are distinct, 
elevated, distended, and scattered over the surface of the 
body: in the latter they are numerous, depressed, and con- 
fluent, or coherent. 

What is the time between the reception of the variolous 
virus and the appearance of its effects? This is called the 
period of incubation, and varies from nine to fourteen days. 

What are the stages of this disease? The initiatory, tho 
eruptive, the maturative, and the declining. 

What are the symptoms of the initiatory stage. -Rigors, 
followed by fever, ? pain in the limbs, back, and epigastrium, 
with vomiting, very similar to gastritis. 

At what period does the eruptive siage appear? About 
the end of the third or beginning of the fourth day; somo 
say sooner. It commences on the face and extends over 
the whole body in about twenty-four hours. 

At what period does the maturative stage occur? It is 
completed about the twelfth day, and preceded by exacer- 
bations of fever, swelling of the face and other paits ; for three 
or four days. 

What is the period of decline or dessication? It com = 
menees about the twelfth day, and in mild cases, by the six- 
toenth or seventeeth day, the fever subsides. 

At what time is the secondary fever high, in confluent ca- 
ses? At the period of complete maturation or suppuration, 
and during the first part of the declining stage. 

Is small pox apt to be a fatal disease? It is when in the 
confluent form ? but not otherwise. 

What is the treatment? In tho initiatory stage tho pa- 
iiont should be kept cool, and the antiphlogistic course pur- 
sued. Bleeding is proper in some cases; mild cathartics, 
valine draughts and James 3 powder may generally bo used ; 
but others require an opposite course. 

In tlie secondary fever, the treatment should be governed 
by the condition of tho patient, which varies much in dif- 
ferent cases. In the mild forms little elso is needed except 
mention to tho bowels. 

Varicella or Chicken Pox. 
W&at arc tho symptoms? Fever, mostly slight, contlnii- 



PRACTICE OF MEDICINE 



ing from one to three days, terminating in a vesicular erup- 
tion which soon becomes shrivelled and falls in scales about 
the ninth or tenth day. 

What is the treatment? When* treatment is necessary it 
should be the same as that for mild cases of small pox, 

Rubeola. 

What are the symptoms? Tho period of incubation is 
generally from five to seven days. The first symptoms are 
those of catarrhal fever, followed by an eruption on the 
third or fifth day, of small red spots on the face, then on 
the neck, body, and extremities. They run into each other 
and form semi-lunar or crescentie patches, and are at their 
height of developement during the second day. Diarrhoea 
is a very common attendant. 

What is the treatment? In general all that is necessary 
is to keep the bowels open, and give tepid diluent drinks 
freely. When complicated the treatment must be modified 
according to the symptoms. 

Scarlatina. 

What are? the essentia] phenomena of the disease? Fever, 
a peculiar ertlption, and inflammation of the fauces, which 
sometimes terminates rapidly in sloughing and ulceration. 

How is it divided? Into s. simplex, g. anginosa, and 5, 
maligna. 

What are the symptoms of s. simplex? They are fever, 
generally followed by a scarlet eruption within forty-eight 
hours, commencing on the face and extending to the neck, 
trunk, and extremities, with a slight soreness of the throat. 
Both usually begin to decline about the fifth day, the skin 
desquamating. 

What are the symptoms of the anginose variety? They 
are more severe than in the former, tho eruption does not 
appear until the third day of fever, and then in irregular 
patches. In some cases there is sloughing, but not always. 

What are the symptoms of the malignant? It commences 
like the preceding, and soon becomes violent and danger- 
ous. The period of eruption varies from the second to the 
fourth day. Grey sloughs which become dark are observa- 
ble in the throat; the functions are all much disturbed, and 
death frequently occurs early in the disease from cerebral 
oppression. 



PRACTICE OF M EDIC IN E> 



313 



Tbm prognosis of scarlatina varies very much in different 
eases, and according to the variety, 

What is the treatment ? There can be no general direc- 
tions given applicable in all cases. We must bo guided by 
general principles* 

Hemorrhages, 

What is hemorrhage? The escape of blood from vessels 
in which it is contained in a healthy state of the system. 

What are the indications in the treatment of hemorrhage? 
To lessen the momemtnm of the circulation if necessary; 
to diminish the determination to the part from which it oc- 
curs; and to excite a contraction of the vessels of the part. 

The first indication may be fulfilled by blood letting, ni- 
tre, digitalis, cold, §c; the second by counter irritants and 
the direct application of cold; and the last by astringents 
either local or general. 

Phlegmasia Doiens. 

What are the symptoms? Pain and stiffness in the groin 
of one side, rigors followed by fever, the limb becomes 
-^vyollen, painful, tender, and of a knotted feel; the skin has 
a pale f white, smooth, and glabrous appearanee. It is pe- 
culiar to the puerperal state, the breasts become flaccid, and 
their secretion is suspended. 

What is the treatment? Decidedly antiphlogistic; blood 
letting, purgatives, antimoniais, &c; after which opium, so 
as to allay pain and irritation may be proper. As local ap- 
plications, leeches, fomentations, solution of muriate of 
ammonia, and stimulating linaments may be useful accord- 
ing to circumstances. 

Apoplexy, 

What is apoplexy ? It is a disease characterized by a 
sudden suspension of the animal functions, a slow and full 
pulse, laborious or stertorous breathing, with a continuance 
of the vital functions. 

What are the premonitory symptoms] Determination of 
blood to the head, indicated by throbbing and turgidity of 
the vessels, vertigo, ringing in the ears, pain, &c. 

What are the terminations of an attack of apoplexy? 
In death during the paroxvsm. 

27* 



314 



PRACTICE OF MEDICINE. 



In perfect restoration of all the suspended functions. 
In paralysis of certain parts of the body, with restoration 
of the functions in other respects. 
And in a general febrile condition. 

How may it be distinguished from syncope and asphyxia? 
In these conditions the pulse and respiration are absent, or 
nearly imperceptible. 

What is the prognosis? Unless appropriate and energet- 
ic treatment soon make a favorable impression on it, the 
case is hopeless. 

The duration of the attack may vary from a few minutes 
to several days. It generally occurs between the fortieth 
and sixtieth years of age. 

What are tho causes'? Besides the predisposing from pe- 
culiar conformation of the body, age, plethora, and organic 
affections of the heart or large vessels, it may be excited by 
over distention, improper food, straining, intoxication, mental 
excitement, the repulsion of cutaneous eruptions, impeded 
circulation, <^c. 

What are the anatomical appearances'? Vascular turge- 
sconce of the brain, sanguineous extravasation, effusion of 
serum, and occasionally little or no traces of disease are 
discoverable. 

What is the treatment? The grand indication is to re- 
move the vascular engorgement of the brain; which is best 
accomplished by bloodletting general and local, the appli- 
cation of revulsives to other parts of tho body, with cold to 
the head. Active purgatives, emetics when the stomach is 
overloaded, and blisters, are important moans. 

What is tho prophylactic management when the premon- 
itory symptoms exist? A simple diet, exercise in the open 
air, avoidance of stimulating drinks and mental excitement, 
gentle cathartics if indicated, reduction of plethora, and an 
active course of life. 

Paralysis or Palsy. 

What is paralysis? Impaired or abolished power of vol- 
untary motion or sensation, or both, in some parts of tho 
body without coma or loss of consciousness. 

What are the different kinds of paralysis ? Hemiplegia, 
when the whole of one side of the body is afTected. 

Paraplegia, palsy of both inferior extremeties from the 
hips downward. 



PRACTICE OF lUEDICIXE. 



315 



And partial, when" some one particular part is affected. 

What is the most common form of it? Hemiplegia, and 
it depends upon a similar condition of the brain to apoplexy, 

Upon what does paraplegia generally occur 2 Affections 
of the spinal marrow generally. 

What are some of the causes of partial paralysis'? Affec- 
tions of the brain or spinal marrow, injury of a nerve, and 
the action of lead. 

What is the treatment? Tho same as for apoplexy in 
most cases. The pulse must be our guide in the employ- 
ment of the lancet; electricity is often useful, particularly 
in the partial variety; nux vomica, rhus toxicodendron, oil 
of turpentine, arnica flowers, and galvanism may also be 
tried, in chronic cases. 

Epilepsy. 

What is epilepsy?- A disease of the nervous system, man- 
ifested by convulsions at uncertain periods, in paroxysms, 
with a temporary loss of consciousness and voluntary mo- 
tion, terminating in sleep. 

What part of the brain is usually found diseased in post 
mortem examinations? The cerebellum. 

What is the treatment? The cause should be carefully 
ascertained, and the treatment modified accordingly. 

What are the remedies which have been thought to pos- 
sess controlling power in this disease] Valerian, enisle toe, 
oil of turpentine, peony root, agaricus muscarius, arteme>ia 
vulgaris, belladonna, opium, stramonium, musk, castor, as- 
safcetida, phosphorus, oxide of zinc, sulphate of zinc, nitrate 
of silver, ammoniatcd copper, indigo, ecc. 

Chorea or St. Vitus 1 Dance. 

What are its characteristics? Incomplete subserviency 
of the muscles of voluntary motion to the will, rendering 
their actions irregular, tremulous, and ridiculous. It may 
be general, or confined to particular muscles. 

What are the causes? Derangement of the bowels, men- 
tal excitement, and all causes of constitutional debility. 

What is the treatment ? It should depend upon the con- 
dition of system producing or accompanying it ; to which 
the treatment should be adapted. Among the remedies re- 
commended are purgatives, the vegetable and metalic ton- 
ics, belladonna, cimicifuga, counter-irritants, galvanism, &c. 



316 PRACTICE OF MEDlfclNE, 



Convulsive Affections of Infants, 

What are tho exciting causes? Any causes which pro- 
duce turgescence of the brain; the most frequent of which 
are intestinal irritation, dentition, worms, repelled cutane- 
ous eruptions, plethora, and local injuries. 

What are the indications in the treatment? To obviate 
the influence of the exciting cause ; to allay norvous or cere- 
bral irritation; and to protect the brain from the determina- 
tion to it. 

Tetanus. 

What is tetanus ? It consists in violent tonic spasms of 
the voluntary muscles, with the power of sensation and 
thought unimpaired. 

How is tetanus divided? According to the part which is 
affected; when confined to the muscles of the jaw it is 
called trismus; when the extensor muscles of tho trunk and 
extremities are the seat opisthotonos ; emprosthotonos, when 
the body is curved forwards, and pleurothotonos when in a 
lateral direction. 

When it occurs in children it is called trismus nascentium. 
It has also been divided into idiopathic and symptomatic; 
the former is produced by direct irritation of the nervous p 
system, and the latter by indirect; that following wounds is 
called traumatic, and belongs to the symptomatic variety. 

What are the symptoms? Slight spasms about the larynx, 
a feeling of stiffness of the jaws, neck, and shoulders, with 
spasms. When it terminates fatally it is usually by apoplexy. 

What is tho treatment? In the idiopathic, particular at- 
tention should be be given to the condition of tho system, 
and thejreatmont adapted to its condition accordingly. In 
thejsymptomatic, attention'both to the general condition, and 
to the local cause of irritation, is necessary. 

The remedies that have been used are blood-letting, pur- 
gatives, sedatives, particularly opium, tobacco, antimony, hy- 
drocyanic acid, cold affusion, mercury, amputation, tonics, 
wine, bark, <^e., all of which jnay be proper when rightly 
adapted. 

Mental Derangement, 

What are the causes? They are hereditary and oxciting; 
the latter of which is divided into moral or those which ope- 



PRACTICE OF MEDICI3S1 



rate through the medium of the mind, anil physical, or those 
which act directly on the body. 

How are diseases of the 'mind divided? Into manin, 
monomania, dementia and idiotism. 

What are the characteristics of Mania? General mental 
derangement, characterized by a rapid succession of inco- 
herent ideas, and violent excitement of the passions, ex- 
pressed by great agitation, loud vociferation, singing, men- 
aces, and fury. 

What are the characteristics of Monomania? It is a state 
of partial insanity, where the patient is insane on one sub- 
ject only, with a full and regular use of his intellectual fac- 
ulties on all or most other subjects. It comprehends many 
varieties as nostalgia, fanaticism, hypochondriasis, melan- 
cholia, misanthropy, <$rc. 

What are the characteristics of Dcmential There is an 
association of unrelated perceptions or ideas, from an ina- 
bility of the mind to judge and reason. 

What arc the characteristics of Idiotisml It consists in 
a defective development or impairment of all the intellectu- 
al faculties, sometimes amounting to total absence of mind. 

What is the general treatment of mental derangement? 
The patient should be removed from his friends and home, 
placed in some quiet and secluded situation, have kind and 
humane treatment, free exercise in the open air, such em-, 
ployment and amusements as are adapted to his condition 
and appropriate remedies, adapted to the general state of 
health and condition. 

De!iriu??i Tremens— -Mania a Potu. 

What are the characteristics? General inquietude, tre- 
mors, continued Watchfulness, cool skin, perspiration, deli- 
rious loquacity, and sensorial illusions; occurring in habit- 
ual drunkards and opium eaters, generally following- the in- 
termission of their accustomed stimulant. 

W r hat is the treatment? Emetics, opium, anti-spasmo- 
dies, and the alcoholic treatment, all have their advocates. 
The alcoholic treatment has been found the mo t success- 
ful in the Philadelphia Hospital; but the treatment with 
opium i.s perhaps more generally practiced than any other, 
cither alone, or in combination with camphor and assafcetida. 
Pertussis or Hooping Cough. 

What is pertussis? It is a contagious cough, which has 



318 PRACTICE OF MEDICINE. 



a regular rise, progress, and declension, and occurring but 
once in the same individual. 

What are the symptoms? It commences as an ordinary 
catarrh with lassitude, sneezing, head-ache, and hoarseness, 
followed by a dry ringing cough, which at the end oi two 
or three weeks becomes convulsive or spasmodic, and in 
paroxysms. 

What is the prognosis? It rarely terminates fatally, ex- 
cept by the supervention of bronchitis, hydrocephalus, 
pneumonia, apoplexy, or marasmus. The younger the pa- 
tient the morq apt is the disease to terminate fatally. It of- 
ten calls into action strumous and tuberculous afFections. 

What is the treatment? It is capable of being mitigated, 
but not cut short in its course. When attended with inflam- 
matory symptoms, blood-letting general and local, may be 
serviceable, and when the lungs are oppressed by the bron- 
chrial secretions, emetics are indicated. Assafcetida is an 
excellent remedy with or without nauseants. Belladonna, 
lobelia, and counter-irritants, are also valuable remedies. 
Asphyxia or Suspended Animation, 

What are the causes which produce asphyxia? Hanging, 
drowning, or strangulation, and the inhalation of some irre= 
spirable gas; also lightning or electricity, and intense cold, 

What are the symptoms of asphyxia from drowning? A 
tinged and livid appearance of the face, the eyes are open 
and staring, limbs stiff, tongue protruded, the epigastrium 
tense and tumid, and the manifestations of life are dostroy^ 
ed. According to Orfila more or less water enters the 
stomach, by which he distinguishes between cases of drown- 
ing, and cases where life was destroyed before being placed 
in the water. 

W r hat is the treatment? The person should be well dried, 
wrapt in blankets, and placed in a convenient place for ar- 
tificial inflation of the lungs, by a common bellows. # Gal- 
vanism and electro-magnetism if at hand, stimulant injec- 
tions into the rectum, and frictions may be very useful, in 
assisting to establish respiration, and revive the energies of 
the system. Heat should be applied by warm flannel, bot^ 
ties of hot water, bricks, &c, in a gradual manner. When 
the functions are partially resumed stimulus carefully 
adapted, may be useful, and the patient should be kopt per. 
fectly at rest in a dry warm bed. These means should be 
persevered in and not abandoned too hastily 



PRACTICE OF MEDICINE. 



319 



What arc the symptoms of asphyxia from tho inhalations 
of carbonic acid gas? When undiluted it will quickly de- 
stroy life, but mixed with atmospheric air it is less sudden, 
producing vertigo, faintings, insensibility, and asphyxia; in 
which case tho face has a tumid and livid appearance; the 
blood vessels are turgid, and tho tongue swollen. It acts 
both by excluding the atmosphere, and as a poison. 

What is the treatment? When the asphyxia is incom- 
plete, recovery will soon take place by placing the patient 
in the open air, dashing a little cold water upon him, dry 
frictions, and wine and water. W 7 hen perfect, the cold dash, 
or pouring water on the head will often excite respiratory 
movements, frictions with dry flannels or stimulating sub- 
stances, volatile applications to tho nose, &c, are proper. — ■ 
If these do not quickly excite respiration, artificial respira- 
tion should be resorted to. 

What is tho treatment of asphyxia from electricity ? The 
same as that for asphyxia from carbonic acid, and other me- 
phitic gasses, cold effusions are particularly valuable in such 
cases. 

What is the treatment of asphyxia from cold? The prin- 
cipal means is tho gradual communication of warmth to tho 
body; but it has to be done with tho greatest caution, or it 
will destroy the little remaining vitality, or produce gan- 
grene. The first applications then should be cold water or 
snow, then dry blankets in a room without fire; gentle fric- 
tions, and artificial inflation of the lungs, unless respiration 
lakes place. If symptoms of life occur, the warmth may be 
increased, and warm chinks administered, of balm or sage 
tea, but stronger stimulants should be avoided. 

Diajrhoca. 

What are the characteristic symptoms? Frequent, and 
usually copious liquid feculent stools, with griping. 

What is the morbid condition upon which diarrhoea de- 
pends? An irritated condition of tho mucous membrane of 
tho bowels, either from the action of irritating substances 
upon it, or from an increase in its irritability, in which case 
the ordinary secretions and contents of the canal will pro- 
duce excessive peristaltic action. 

What are the indications of treatment ? - To removo every 
source of intestinal irritation; to allay the morbid irritability 
of tho mucous membrane of the bowels; and to diminish the 
determination of the blood to the intestinal canal. 



320 



HiACTlCE OF MEDICINE. 



Cholera, 

What are the characteristic symptoms } Frequent, violent 
vomi ting and purging, with severe tormina, and cramps in 
the muscles. 

What are the indications of treatment? To allay as 
quickly as possible the irritability of the stomach and bow- 
els, to restore the action of the skin and liver, and to deter- 
mine the circulation from the internal to the* external parts. 
Energetic means should at once be resorted to for these 
purposes, and opium, calomel, and active revulsives will 
generally fulfil the indications. 

Flatulent Colic, 

What condition of the digestive organs predisposes to this 
disease ? A weak, and irritable state of them. Ordinary 
articles sometimes, but particularly substances not easily 
digested, are mostly the exciting causes. 

What are its characteristics'? Fain in the stomach and 
bowel s, sooner or later after eating, occurring in paroxysms, 
with short remissions, eructations of wind, and torpid bow- 
els. It may be distinguished by the relief obtained from 
abdominal pressure, the writhing motions of the patient, 
and the absence of fever. From bilious colic by the absence 
of bilious vomiting; and from colica piclonum by the hard- 
ness and retraction of the abdominal muscles, and the grad- 
ual accession of the colic produced by lead. 

What is the treatment ? When the symptoms are slight, 
frictions with a flannel or a brush, and the milder carmina- 
tives and antispasmodics are all that may be required. When 
more severe, camphor, ether, laudanum, cSzc. may be neces- 
sary; but when the irritating substance still remains, and 
the pains do not abote, proper cvacuants must be resorted 
to : emetics, if the offending .substance is still in the stomach ; 
and cathartics, or laxatives, if it have- passed into the intes- 
tines. Revulsives, such as sinapism?, heat, &c. applied to 
the abdomen are useful. In convalescence great care should 
be taken in regard to diet. 

Bilious Colic. 

What is bilious colic ? It. is a variety of colic with mani- 
fest derangement of the biliary organs. 

What are the causes? "It depends upon the same remote 



PRACTICE OF MEDICINE. 



321 



causes which produce intermitting and other forms of mias- 
matic fevers; and generally occurs during the autumnal 
months. 

What arc the symptoms? In the first stages the symp- 
toms resemble those in the forming stages of miasmatic fe- 
vers. These are followed by acute pain in the stomach and 
bowels, which is very severe during the exacerbations, As 
the disease advances the abdomen becomes tender to the 
touch. Nausea -and bilious vomiting occur often at tho 
commencement of the disease, the bowels are torpid, the 
pulse is not much disturbed at first, but becomes increased 
in fullness, force, and frequency, as the disease advances, 
and there are symptoms of bilious derangement. 

What is the treatment? The principal indications are, to 
free the bowels of their irritating contents; to allay the mor- 
bid irritability of the stomach and intestinal tube, and to re- 
store the healthy secretions of the liver. The first indication 
can be accomplished by an emetic, if fre9 vomiting does not 
exist, and by cathartics as soon as they can be brought to 
act; but from the usual irritable condition of the stomach, 
tins cannot at onco be done; calomel, in small doses re- 
peated, then becomes the most important remedy conjoined 
with revulsives, which will generally allay the irritability 
of tho stomach, and bring the system under its: peculiar in- 
fluence; which is favorable to the operation of cathartics, 
and tho restoration of the secretions. As a purgative, cas- 
tor oil and spirits of turpentine, as soon as the stomach will 
bear them, will be found beneficial. Warm bath, fomenta- 
tion, blood-letting, ccc. may be found useful during the 
course of treatment, according to the condition of the system. 



28 



PART VII — POISONS, 



What are poisons? Substances which produce death or 
serious injury when applied in considerable quantities, eith- 
er externally, or internally. 

Are poisons similar in their action? No; each one pro- 
duces symptoms peculiar to itself. 

What is the first great object in the treatment of poisons? 
To administer an antidote. 

How many kinds of antidotes are there? Two; one de- 
stroys the deleterious qualities of the poison before its inju- 
rious action is developed; and the other controls the poison- 
ous action after it has been established. 

What other means are resorted to? Evacuation of the 
stomach either by an emetic, or stomach pump, when ta- 
ken internally ; and by excision, or the application of a cup- 
ping glass, if applied externally. 

Acids. 

What are the symptoms of poisoning by nitric, muriatic, 
and sulphuric acids? Burning heat in the mouth, oesopha- 
gus, and stomach, acute pain, eructations, nausea, hickup, 
vomiting, tenderness of abdomen, coldness of surfaco and 
extremities, depressed pulse, horrible contortions, excessive 
thirst, and generally a fatal termination. 

What is the treatment? Repeated doses of magnesia, 
alkalies or their carbonates, and alkaline earths, as antidotes ; 
mucilaginous drinks, olive, or almond oil in large quanti- 
ties, emollient fomentations, and clysters. 



POISONS 



323 



Alkalies, 

What are the antidotes? Vegetable acids, of which com* 
mon vinegar is the best; also fixed oils in largo quantities, 

AxTIMONY. 

By what preparation of antimony is poisoning usually pro- 
duced) The emetic tartar. 

What are the effects as a poison? A severe metallic taste, 
nausea, copious vomiting, hickup^ burning pain in the sto- 
mach, colic, frequent stools and tenesmus, difficult respira- 
tion, fainting, small quick pulse, cold skin, loss of sense, 
cramps, prostration, and death. 

What is the treatment) If emesis does not take place- 
it should bo promoted by tickling the throat, and diluent 
drinks; antidotes should be administered; among which are 
decoction of galls, Peruvian bark, common tea, &c. If tho 
vomiting is excessive give laudanum, and apply revulsives 
froely; the consecutive treatment should bo adapted to the 
condition of tho disease existing. 

Arsenic. 

What preparation of arsenic is generally used in poison- 
ing? The arsenious acid, sometimes called white oxid^. 

What are the symptoms? It is a violent poison, whether 
applied internally or externally. Its symptoms are an aus- 
tere taste, hawking, constriction of the throat, hiccup, nau- 
sea, anxiety, frequent sinkings, pain at the precordia, vomi- 
ting, black foetid stools, frequent irregular pulse, insatiable 
thirst, delirium, convulsions, loss of feeling, especially of 
the feet and hands, and death. 

What are the usual morbid appearances after death ? In- 
flammation of the mouth, stomach, and intestines; spots re- 
sembling eschars on the stomach and duodenum; perfora- 
tions of their coats; and the villous coat of the stomach is 
reduced to the consistence of a reddish brown pulp. 

What is tho treatment? Before the antidote can usually 
be procured the poison should be dislodged by an emetic of 
sulphate of zinc or copper, tickling the throat, &c. or by the 
stomach pump. Demulcents should be froely given both 
before and after vomiting. As an antidote in all cases for 
tho poisonous compounds of arsenic, the hvdrated sesquiox- 
itlo of iron in a moist or pulpy state should be given as soon 



324 



POISONS. 



as possible in doses of a tablespoonful to an adult, of a des- 
ertspoonful to children, every five or ten minutes until ur- 
gent symptoms are relieved. The after symptoms should 
be combated on general principles. 

As tho hydrated sesquioxide of iron is the only known 
antidote to be relied on in cases of poisoning by arsenic, I 
will here give the formula for its preparation. Every apoth- 
ecary, and country physician should keep it always on 
hand. 

Hydrated Peroxide of Iron. 
R> Sulphuric acid (67 Q Baume,) 8 oz. 16 parts. 
Iron wire, 8 oz. 16 ** 

Nitric acid, (49° Baume,) 5k oz. 11 " 
Water of ammonia, q. s. 

Water. 14 gal. 384 " 

Mix the sulphuric acid with the water in a glass vessel; 
then add the iron; and after the effervescense has ceased, 
filter. Add the nitric acid in .divided poitions, and apply 
hoat so long as orange colored fumes are given off. To 
the heated solution pour in the water of ammonia until a 
decided excess has been added; then wash the precipitate 
by decantation until the washings give no precipitate with 
nitrate of baryta. The water is then to be drawn off until 
just enough remains to give tho consistence of thick cream. 
It should then be kept in bottles of convenient size for use, 
and given as above when required. 

Barytes. 

What preparations of baryta are pobonous? Tho carbo- 
nate, muriate, and nitrate. 

What are the symptoms produced by large doses? Vio- 
lent vomiting, purging, and other dangerous symptoms. 

What is the treatment? Dilute sulphuric acid, and the 
soluble sulphates are antidotes, converting it into an insolu- 
ble sulphate of baryta. Emetics should also bo given. 

COPFER. 

What are the poisonous preparations of copper? The ace- 
tate and sulphate. Poisoning, from copper, usually occurs 
from the careless use of culinary vessels, or mineral water 
fountains. 

What are the symptoms of poisoning by the salts of cop- 
per? A coppery* taste, pain in tho head, nausea, vomiting, 
catharsis, colic, cramp, convulsions, insensibility, and death. 



POISONS. 



3*25 



What is the treatment ? Albumen, in the form of white 
of eggs, copious draughts of warm milk, and brown sugar, 
or molasses are the best antidotes. Iron filings are also used. 
Gold. 

What is the poisonous preparation of gold ] The nitro- 
muriate. 

What is the antidote ? Sulphate of iron which precipi- 
tates the gold; mucilaginous drinks should also be freely 
used. 

Lead. 

What are the poisonous preparations of lead in common 
use! The carbonate and acetate. 

What is the most common form of the effects of poisoning 
by lead? Colica pictonum. 

What is the best prophylactic? TIig constant use of di- 
lute sulphuric acid in some form or other. 

Wliat is the proper antidote lor the preparations of lead? 
The soluble sulphates, as magnesia or soda, and the phos- 
phate of soda. Emesis should also be produced by sulphate 
of zinc. 

Mercury. 

What are the poisonous preparations? They are all, but 
corrosive sublimate in particular. 

What are the symptoms of poisoning by corrosive subli- 
mate? It produces an intolerable astringent taste, con- 
striction of the gullet, nausea, vomiting, burning pain, 
diarrhoea, and a flushed swollen face. 

What is the treatment? Albumen of eggs, or gluten in 
the form of unboiled wheat flour paste, should be copiously 
swallowed as an antidote and the stomach evacuated either 
by an emetic or the stomach pump. If neither albumen nor 
gluten is at hand, milk should be drank freely. 

The treatment for its effects should be conducted on gen- 
eral principles for the reduction of inflammation, &c. 

Nitre. 

What arc the symptoms produced by a poisonous dose of 
nitre? Heat and pain in the stomach, vomiting and purging 
of blood, prostration, convulsions, and death. 

What is the treatment? Its speedy removal by an emetic 
or stomach tube, the administration of demulcent drinks, 
laudanum, cordials, #c. There is no known antidote. 
29 



326 POISONS. 

Oxalic Acid. 

What are the symptoms produced ? it produces death 
suddenly and certainly, in largo doses. 

When concentrated it produces exquisite pain, followed 
by violent efforts to vomit, then sudden dullness, languor, 
debility, and finally death, without a struggle. When dilu- 
ted largely it is neither corrosive or very irritating, but 
causes death by its action on the brain, spinal marrow and 
heart. 

What is the treatment? Remedies should bo applied 
promptly. The antidotes are, chalk or magnesia, mixed with 
water and administered in large quantities. If the anti- 
dotes aro not at hand, the stomach should be speedily evac- 
uated by tho usual means. Avoid warm water and the 
alkalies. 

Silver. 

What preparation of silver is most likely to bo used as 
a poison? The nitrate. 

What arc tho symptoms? Tho usual effects of the cor- 
rosive poisons. 

What is the treatment? Common salt is the proper anti- 
dote. Mucilaginous drinks should be freely given so as to 
produce vomiting. Consecutive inflammations should be 
treated according to the indications. 

Tin. 

What are tho proper antidotes for tho salts of tin? Eggs 
or milk in largo quantities. 

Zinc 

What is tho remedy for an over doso of the sulphate of zinc? 
Warm water, emoliont drinks, milk, and albumen. 

Narcotics. 

What is tho general treatment applicable where narco- 
tics have been swallowed? Active emetics, of which sul- 
phate of zinc in large doses stands first, the stomach pump 
and tube should also bo used to wash out this organ, after 
which coffee, vegetable acids, &c, are proper. There are 
no antidotes to be absolutely relied on. 

Opium. 

What are the symptoms of poisoning by opium and its 
proximates? The pulse is reduced in frequency but not in 



POISONS 



force, muscular strength is diminished, there is languor, 
drowsiness, apoplectic sleep, stertor, suffusion of counte- 
nance, insensibiiitv, coma, full, slow pulse, followed by 
cold clammy skin, cold extremities, pallid countenance, 
thread like pulse, interrupted gasping respiration, and death, 
unless relief is afforded. 

What is the treatment?- Evacuation of the stomach by 
the pump, or an active emetic, of which sulphate of zinc is 
the best, and its action should be promoted by the usual 
means. After the stomach has been evacuated, dilute vin- 
egar, stimulants, sinapisms, and frictions, may be called for. 

The patient should be bled if necessary, kept roused as 
much as possible by cold to the head, and by the action 
of an electric or electro-magnetic machine, or flagellation ; 
and artificial respiration should also be kept up, until the 
system can rally. — An infusion of galls has been consid- 
ered as an antidote, but there is no course to be relied on 
excepting the above. 

Hyusccyaijic Acid. 
What are the symptoms in poisoning by it? It is so rapid 
in its action that it is seldom treated by a physician. When 
it is not at once fatal, the symptoms are sudden loss of sense, 
trismus, difficult and rattling respiration, coldness of the ex- 
tremities, a smell of bitter almonds proceeding from the 
mouth, small pulse, swelling of the neck, immobility of the 
pupils, sometimes contracted, and at others dilated, convul- 
sions, t^C. 

What is the treatment? The antidotes are chlorine we ::\ 
ammonia, cold effusion, and artificial respiration. 

Buckeye, (Eseulus Ohioensis.) 
What is its antidote? Chlorine, iodine, and bromine. 

Chloelne, (gaseous.) 
What is the antidote? Inhale ammonia cautiously. 
Dic-itaus. 

What are the symptoms of a poisonous dose ? Nausea 
and vomiting, stupor or delirium, cold sweats, prostration, 
hiccup, convulsions, and syncope. 

What is the treatment? Evacuation of the stomach as 
speedily as possible, and counteract its effects by stimu- 
lants, as brandy, ammonia, 6ec. Infusion of yellow bark is 
considered as its antidote. 



POISONS, 



Ipecacuanha. 

Whnt is the proper treatment for an over dose? Chlorine, 
iodine, and bromine, are considered as antidotes, but the 
general treatment should be that which is indicated by the 
general symptoms. 

Jalap. 

What is the treatment'} Antidotes, same as preceding, 
general treatment according to the symptoms. 

Strammonium. 

What are the symptoms when taken in a poisonous dose? 
Cardialgia, thirst, nausea and vomiting, sense of strangula- 
tion, anxiety, and faintness, defect or loss of vision, dilata- 
tion of the pupils, vertigo, delirium, tremors, palsy, stupor, 
convulsions, and sometime death. 

What is the proper treatment? Evacuation of the stom- 
ach. Antidotes, same as the preceding. 

Nux Vomica. 

"What are its poisonous symptoms? Difficult and con- 
fined breathing, retching to vomit, tremors, spasms, convul- 
sions, and death, sometimes takes place. 

What is the treatment? Antidotes same as preceding. — • 
Evacuation of the stomach, and general treatment accord- 
ing to symptoms. 

Phosphorus. 

What are the symptoms of poisoning by phosphorus? 
The principal one is violent pain and irritation of the 
stomach. 

What is the treatment? The stomach should be evacua- 
ted, and magnesia and water freely given as an antidote, 
both before and after vomiting. 

Stings of Insects. 
What is the proper remedy? Wash in water of ammonia. 

Bites of Serpents and Rabid Animals. 
What is the remedy? Cut out the part if it can be done 
early, apply a ligature, and cup the wound. 




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